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Sulfonamides and Nitrofurantoins Linked to Birth Defects

Patients may ask about a widely reported, case-control study suggesting that certain antibacterial drugs, including sulfonamides and nitrofurantoins, are associated with increased risk for birth defects. The findings appear in the Archives of Pediatrics and Adolescent Medicine.

Some 13,000 women who had infants with birth defects, and nearly 5000 control mothers whose infants did not have defects, completed interviews on their use of antibacterial drugs from the month before conception through the 3 months afterward.

Among the findings:

• Sulfonamides were associated with the most types of defects, such as anencephaly and left-sided heart defects.
  
• Nitrofurantoins were also linked to several defect types, including hypoplastic left heart syndrome.
  
• Penicillins, erythromycins, cephalosporins, and quinolones were largely unrelated to defects.
  

The authors conclude that their study "lends support to the established safety profiles" for certain antibiotics (e.g., penicillins), but that the increased risks observed with sulfonamides and nitrofurantoins indicate "a need for additional scrutiny."

LINK(S):

Archives of Pediatrics and Adolescent Medicine article (Free abstract; full text requires subscription)

Associated Press story (Free)

Published in Physician's First Watch November 4, 2009