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UTILISATION DES ANTI-INFECTIEUX ET GROSSESSE Ce Tableau N’A Qu’Une Valeur Indicative Et Ne Constitue Qu’Une Aide À La Prescription

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UTILISATION DES ANTI-INFECTIEUX ET GROSSESSE Ce Tableau N’A Qu’Une Valeur Indicative Et Ne Constitue Qu’Une Aide À La Prescription UTILISATION DES ANTI-INFECTIEUX ET GROSSESSE Ce tableau n’a qu’une valeur indicative et ne constitue qu’une aide à la prescription. L’évaluation devra se faire au cas par cas. Pour plus d’information, contacter le Centre Régional de Pharmacovigilance au 04 73 75 48 31. CONDUITE A TENIR D’UTILISATION ANTI-INFECTIEUX 1er TRIMESTRE 2ème TRIMESTRE et 3ème TRIMESTRE · Possible : 1ère intention : amoxicilline, ampicilline, Pénicilline V, G, amoxicilline-acide clavulanique PENICILLINES · Possible : 2ème intention : cloxacilline, oxacilline, ampicilline-sulbactam, pipéracilline, pipéracilline-tazobactam, ticarcilline, ticarcilline-acide clavulanique · Possible : 1ère intention : C1G (céfadroxil, céfalexine, cefaclor) ; C2G (céfuroxime) ; C3G (ceftriaxone) · Possible : 2ème intention : C1G (céfalotine, céfatrizine, céfazoline, céfradine), C2G (céfamandole, cefoxitine) ; C3G (céfotaxime, ceftazidime, céfépime, CEPHALOSPORINES cefpirome, cefixime, cefotiam, cefpodoxime) · A éviter par prudence : ceftaroline AUTRES BETALACTA- · Possible : 2ème intention : imipénem –cilastatine MINES · A éviter par prudence : aztréonam, doripénème, ertapénème, méropénem · Possible 1ère intention : azithromycine, érythromycine, spiramycine · Possible 2ème intention : josamycine, clarithromycine, roxithromycine MACROLIDES · A éviter par prudence : midécamycine · Déconseillé : télithromycine STREPTOGRAMINES · Possible 2ème intention : pristinamycine · Possible 1ère intention : clindamycine · Possible 1ère intention : clindamycine LINCOSAMIDES · A éviter : lincomycine · Possible 2ème intention : lincomycine · Possible 2ème intention : teicoplanine, vancomycine. GLYCOPEPTIDES · Prévoir un bilan auditif (otoémissions) chez le nouveau-né, en particulier en cas de traitement prolongé ou d’association à un aminoside. · Possible 2ème intention : acide pipémidique QUINOLONES · Si pas d’alternative : ciprofloxacine, norfloxacine · A éviter par prudence : acide nalidixique, ofloxacine, pefloxacine, levofloxacine, moxifloxacine, loméfloxacine, enoxacine, fluméquine FOSFOMYCINE · Possible 2ème intention TETRACYCLINES · A éviter par prudence · Contre-indication 62 CONDUITE A TENIR D’UTILISATION ANTI-INFECTIEUX 1er TRIMESTRE 2ème TRIMESTRE et 3ème TRIMESTRE · Pas ou peu de données mais aucun élément inquiétant rapporté à ce jour donc envisageable en cas d’infection maternelle sévère : amikacine, gentami- cine, tobramycine, netilmicine, et uniquement en dose unique pour la spectinomycine. AMINOSIDES · Prévoir un bilan auditif chez le nouveau-né (otoémissions), en particulier en cas de traitement prolongé ou répété · Contre-indication : kanamycine et streptomycine . PHENICOLES · Déconseillés Chez la femme enceinte, le traitement de la tuberculose doit être identique au schéma thérapeutique hors grossesse · Possible 1ère intention : isoniazide + 50 mg/j de vitamine B6 (pyridoxine) · Possible 1ère intention : rifampicine + vitamine K1 (10 mg/j) pendant les 15 derniers jours de grossesse + vitamine K1 (0,5 à 1 mg IM/IV lente) au nou- ANTITUBERCULEUX veau-né en salle de travail · Possible 1ère intention : éthambutol · Possible 2ème intention : pyrazinamide, rifabutine (+ vitamine K1 comme pour la rifampicine) · Déconseillé : sulfaméthoxazole-triméthoprime (cotrimoxazole) sauf en l’absence · Possible 2ème intention : sulfaméthoxazole-triméthoprime (co- d’alternative thérapeutique et indication maternelle justifiée. Associer une sup- trimoxazole), sulfadiazine SULFAMIDES plémentation en acide folique · Possible 2ème intention : sulfadiazine · Possible 1ère intention : métronidazole AUTRES ANTIBIO- · Possible 2ème intention : acide fusidique, daptomycine. TIQUES · Seulement en traitement de courte durée : nitrofurantoine · Déconseillé : colistine, linézolide · Possible 2ème intention : amphotéricine B, fluconazole (1), itraconazole(1) · A éviter par prudence : anidulafungine , terbinafine ANTIFONGIQUES SYS- (2) (2) TEMIQUES · Déconseillé : fluconazole , itraconazole , posaconazole, voriconazole, caspofungine, micafungine, flucytosine, griséofulvine. (1) si traitement ponctuel et/ou dose cumulée < 300mg (2) si traitement prolongé et/ou dose cumulée > 300mg · Possible 1ère intention: clofazimine, dapsone(1) ANTILEPREUX (1) A la dose efficace la plus faible possible 63 CONDUITE A TENIR D’UTILISATION ANTI-INFECTIEUX 1er TRIMESTRE 2ème TRIMESTRE et 3ème TRIMESTRE · Possible 1ère intention : chloroquine, proguanil, méfloquine · Possible 1ère intention : chloroquine, proguanil, méfloquine ANTIPALUDEENS · Possible 2ème intention : atovaquone-proguanil. · Possible 2ème intention : atovaquone-proguanil. (PROPHYLAXIE) · A éviter par prudence : doxycycline · Contre-indication : doxycycline · Possible 1ère intention : chloroquine, quinine · Possible 1ère intention : chloroquine, artésunate IV, quinine(1) · Possible 1ère intention si paludisme grave : artésunate IV · Possible 2ème intention : atovaquone-proguanil, mefloquine, artéme- ANTIPALUDEENS · Possible 2ème intention : atovaquone-proguanil, mefloquine ther-luméfantrine (TRAITEMENT) · A éviter par prudence : halofantrine · A éviter par prudence : halofantrine · Déconseillé : sulfadoxine-pyriméthamine, artémether-luméfantrine. · Déconseillé : sulfadoxine-pyriméthamine · (1) Risque d’hypoglycémie si utilisation en fin de grossesse · Possible 1ère intention : métronidazole ANTI-AMIBIENS · A éviter par prudence : tiliquinol-tilbroquinol, ornidazole, secnidazole, tinidazole. · Possible 1ère intention : ivermectine, pyrvinium · Possible 1ère intention : ivermectine, pyrvinium, albendazole ANTI- · Possible 2ème intention : niclosamide, pyrantel · Possible 2ème intention : niclosamide, pyrantel, flubendazole HELMINTHIQUES · A éviter par prudence : diéthylcarbamazine, pipérazine · A éviter par prudence : diéthylcarbamazine, pipérazine · Déconseillé : praziquantel, triclabendazole, albendazole, flubendazole · Déconseillé : praziquantel, triclabendazole · Possible 2ème intention : amphotéricine B, antimoine LEISHMANIOSE · Déconseillé : pentamidine MICROSPORIDIOSES · Déconseillé : fumagiline · Déconseillé : sulfaméthoxazole-triméthoprime (cotrimoxazole) sauf en · Possible 2ème intention : sulfaméthoxazole-triméthoprime (co- l’absence d’alternative thérapeutique et indication maternelle justifiée. As- trimoxazole) ; dapsone, sulfadiazine PNEUMOCYSTOSE socier une supplémentation en acide folique · A éviter par prudence : atovaquone · A éviter par prudence : atovaquone · Déconseillé : pentamidine · Déconseillé : pentamidine · Possible 1ère intention : spiramycine · Possible 1ère intention : spiramycine, pyriméthamine TOXOPLASMOSE · Possible 2ème intention : sulfadiazine · Possible 2ème intention : sulfadiazine · A éviter par prudence pyriméthamine TRYPANOSOMOSE · Déconseillé : pentamidine 64 .
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