Q: I am in the second month of pregnancy. I have been diagnosed with Typhoid and my doctor has asked me to take three medicines: Paraxin 250 - contains chloramphenicol 250 mg- 1 every 4 hours during the day, Pflomac 200 mg- daily 2 and Polybion. Could you please advise whether it is safe to go ahead with these medicines? Will it have any adverse effect on pregnancy and/or the fetus?

A:You have not given details of tests performed to confirm the diagnosis. This is crucial since you are in the first trimester of pregnancy. The best way would be to send your blood for isolation of germs and antibiotic sensitivity test (AST) to determine the best treatment. Many typhoid germs have now become resistant to chloramphenicol (sold under the trade name of Paraxin, Chloromycetin etc). About 10 years ago this was the drug of choice for confirmed typhoid because germs were sensitive to it. Now one has to test before prescribing. We cannot locate the trade name Pflomac in the data bank of quality medicines in India. May be there is mistake in spellings. You should check its composition. If it contains pefloxacin, then there has to be very strong scientific justification for using two antibiotics i.e. chloramphenicol and pefloxacin at the same time. Besides, the adverse effects of pefloxacin have not been studied during human pregnancy. In case Pflomac contains some other ingredients, please advise us so and the name of the manufacturer so that we give further consideration. Polybion is a usual vitamin/tonic. What you need is folic acid to prevent birth defects and iron to take care of anaemia. You can take Globac-Z Softules one daily till the end of pregnancy. Folic acid is absolutely essential. Once properly treated, there is no problem with pregnancy or fetus.