USE OF CARBAPENEMS IN PREGNANCY

The carbapenems are broad-spectrum beta-lactam antibacterials that include ertapenem, imipenem and meropenem. Imipenem and meropenem are used for the treatment of severe hospital-acquired infections and polymicrobial infections. Ertapenem is used for the treatment of abdominal and gynaecological infections, pneumonia, and skin and soft tissue foot infections in people with diabetes.

There is extremely limited information on the use of carbapenem antibiotics during pregnancy and an evidence-based evaluation of risk to the fetus is therefore not currently possible. Where possible, the results of culture and sensitivity tests should be available before making a treatment choice in accordance with local prescribing guidelines. It is important to ensure adequate treatment of maternal infections in pregnancy as failure to treat may lead to adverse maternal and fetal effects as a consequence of uncontrolled infection or pyrexia.

Exposure to carbapenems at any stage in pregnancy would not usually be regarded as medical grounds for termination of pregnancy. Due to the lack of safety data and the likely severity of infections necessitating use of a carbapenem, additional fetal monitoring may be warranted and should be considered on a case-by-case basis. Other factors which may independently increase the risk of adverse pregnancy outcome may also be present in individual cases. Clinicians are reminded of the importance of consideration of such factors when performing case-specific risk assessments.