Antiobiotics in pregnancy: what to choose

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8 Proven Shortcuts To A Healthy Pregnancy

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As a BC-licensed Naturopathic Physician with full prescribing rights, my scope of practice allows for treating naturally with acupuncture, nutrition/supplements and herbal medicine, while also prescribing antibiotics and other medications when needed. This full scope and training is one of the things that attracted me to Naturopathic Medicine in the first place – having the tools and skills to discern when a patient can recover their health with natural supports, and when pharmaceuticals and more invasive interventions are needed.

In pregnancy, the approach is the same. I always opt to use the least invasive approaches when helping my pregnant patients recover from illness. In the vast majority of cases, this means boosting nutrition, encouraging extra sleep, acupuncture treatments, and the use of herbs like echinacea that have been proven to be safe and effective during pregnancy (for more on this check out this weekly tip).

On some occasions, however, antibiotics are warranted to prevent further complications. Whenever I am in this situation, I look for the safest options available. During pregnancy, prescription medications are given a letter rating to denote their safety. In short, “A” means studies have show them to be safe in human pregnancies, “B” means they have been show to be safe in animal studies but that there are insufficient human studies, “C” means that animal studies have demonstrated harm, and “D” denotes that human studies have demonstrated harm.

Unfortunately there are no Category A antibiotics available for pregnancy. The Category B antibiotics include Penicillin, Amoxicillin, Clindamycin, Vancomycin and Cephalosporins. I stick with these when they are needed.

Antibiotics that have demonstrated harm, including higher rates of miscarriage, include the Quinolones, Tetracyclines, Sulfonamides, Metronidazole, and Macrolides (except erythromycin). These are to be avoided.

I don’t use antibiotics lightly, due to the demonstrated impact on both mom and baby’s digestive and immune function. When I do prescribe them, I always ensure to repopulate mom’s natural flora with a high-potency probiotic (minimum 10Billion CFU per day, up to 100Billion CFU per day) in the months following the antibiotic. This will of course not completely bring mom’s flora back to the natural state, but it does help mitigate some of the negative impacts of the antibiotics.

I hope you have found this helpful, and do let me know if you have any questions!

If you are hungry for more evidence-based information in your pregnancy, sign up for my free webinar: 7 Pregnancy Myths Debunked – and get the information you need to have a healthy pregnancy and a thriving baby.

And if you are a care-provider looking for evidence-based resources for your pregnant patients, please get in touch with us at

In health,

Dr Jocelyn Land-Murphy, ND

Terra Life

Disclaimer: The information and content provided is for general educational and informational purposes only and is not professional medical advice, nor is it intended to be a substitute therefore. Please consult the Disclaimer and Terms of Use for full details.


American Family Physician. (2006). Antibiotic use during pregnancy and lactation. American Family Physician, 74(6): 1035.

Cassoobhoy, A. (2017). Which Antibiotics Should Be Avoided in Early Pregnancy? Medscape, May 05, 2017.

Jedrychowski, W. (2006). The prenatal use of antibiotics and the development of allergic disease in one year old infants. International Journal of Occupational Medicine and Environmental Health, 19(1): 70–76.

Mueller, N. et al. (2014). Prenatal exposure to antibiotics, cesarean section and risk of childhood obesity. International Journal of Obesity,  39(4): 665-670.

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8 Proven Shortcuts To A Healthy Pregnancy

it's free!
Protecting your personal information is of utmost importance to me