Will intake of Ofloxacin during pregnancy pose any danger to the fetus?
Obstetrics and Gynaecology Consultant,
Apollo Hospital, New delhi
Q: I am 8 weeks pregnant. I am concerned about my unborn child's health. I live in Ireland. I went on a 2 week holiday to Latvia. My periods were delayed, before I left for my vacation. But the test showed that I am not pregnant. I took the test again after I reached Latvia and found myself pregnant. I went straight to my doctor who did an ultrasound and took a routine vaginal test. Later I had some cramps in the lower abdomen, fearing a miscarriage I went to the doctor. She had a look at the cervix and saw a stream of blood. She told me that I had a miscarriage and sent me to the hospital to perform D & C. I didn't want to go for it and wanted to wait as the fetus might come out later on. So she prescribed Zanocin 200 mg twice a day to avoid infection. After 2 days, I had lower back pain so I started antibiotics and took them for 3 days. I went to another doctor, who performed ultrasound and said that the pregnancy is OK, the heart is beating and the baby is growing. The cause of bleeding was due to a slight detachment of amniotic sac. I have read that this drug is prohibited during pregnancy and it can harm the bones. It is even not prescribed for children under 16 years of age when skeleton is not formed completely. Will it harm my baby and how badly? Abortion is illegal in Ireland. So they don't tell us about any abnormalities, if seen on ultrasound or other tests. I am scared to give birth to an abnormal child.
A:Ofloxacin (Zanocin) is a Category C drug in pregnancy which means it is not known what effect it has on the baby (pregnancy). It is not approved for use during pregnancy. These drugs (Category C) are given in pregnancy only if benefits outweigh the risks. In animal experiments, in dosages which are enormously higher than what is used in humans, it produced abnormalities and is therefore not used in pregnancy. However nothing definite is known yet. To say that it will definitely produce abnormalities is not true but we do not know what the effect would be. So any counselling based on evidence would be impossible. You can very well have a perfectly normal baby despite the medication and may also have some problems.As far as specific abnormalities caused by Ofloxacin are concerned, nobody is too sure as not much is known. In some animal experiments it had caused bone abnormalities but in doses tremendously higher than what was given to you. In human pregnancy the affect is not known so in all probability nothing will happen in an exposure so early in pregnancy but no body can give you a guarantee it to you.I am sorry to say but you will have to make your own decision. You are in an unenviable position where you may end up aborting a completely normal child on one hand or carry an abnormal one because of poor prescribing. Both the outcomes would be terrible so you need to make a choice between the two and choose the least terrible one. Whether aborting a potentially normal child is less of a tragedy or carrying and having an abnormal one is less terrible. I am afraid you will have to make this choice depending on your outlook.One couple may think that under no circumstances is an abnormal child acceptable in the family as it ruins the lives of the whole family including the child's and all the siblings, on the other hand another one would like to leave it to God as aborting a normal child would not be acceptable to them. You would have to make your decision according to your physical, emotional and spiritual attitudes.I may also warn you that contrary to what most lay people (and probably you also) believe, Ultrasound is able to detect only some abnormality and repeated ultrasound examinations cannot rule out an abnormal baby in all cases.I am not sure what you say about abortions in Ireland. I think abortions have been legalized in Ireland recently but you will have to check that locally. I wish you all the best and hope you are able to take a responsible decision.