Safe Antibiotics During Pregnancy: What Works and What to Avoid

When you're pregnant, taking any medication feels risky—especially antibiotics, drugs used to treat bacterial infections that can cross the placenta and affect fetal development. The good news? Not all antibiotics are dangerous. Some are well-studied, widely used, and considered safe throughout pregnancy. Others? They carry real risks—from birth defects to gut infections like Clostridioides difficile, a severe gut infection often triggered by broad-spectrum antibiotics. The key isn’t avoiding antibiotics altogether—it’s choosing the right ones at the right time.

Doctors often prescribe penicillins, a class of antibiotics including amoxicillin and penicillin V that have decades of safety data in pregnancy for common infections like UTIs or strep throat. cephalosporins, another group of beta-lactam antibiotics often used when penicillin isn’t an option, are also considered low-risk. But things get tricky with tetracyclines, fluoroquinolones, or sulfonamides—these can affect bone growth, joint development, or even cause rare but serious newborn complications. Even antibiotic-associated diarrhea, a common side effect that can turn dangerous during pregnancy due to dehydration and stress on the body, needs attention. It’s not just about the drug itself—it’s about how your changing body handles it, what other meds you’re on, and whether the infection is even bacterial to begin with.

Many women worry that any antibiotic will harm their baby. But untreated infections—like a kidney infection or untreated strep—can be far more dangerous than the medicine. The goal isn’t to avoid antibiotics, but to use them wisely. That means confirming the infection truly needs treatment, picking the safest option based on your trimester, and watching for signs of trouble like unusual cramping, diarrhea, or rash. Below, you’ll find real insights from studies and patient experiences that show which antibiotics are trusted, which ones raise red flags, and how to talk to your provider so you’re never guessing when it comes to your health—and your baby’s.