Is Augmentin Safe to Take During Pregnancy?

What does the evidence say about augmentin during pregnancy?

1. MotherToBaby reports that most studies have not found a higher chance of birth differences after first-trimester amoxicillin or clavulanic acid exposure, while noting that relatively few studies evaluate the combination. 1
2. A prospective controlled study followed 191 first-trimester amoxicillin-clavulanate exposures and 191 amoxicillin-exposed controls with similar indications; major malformation rates were 1.9% and 3.0%, respectively, a nonsignificant difference with a wide confidence interval. 2
3. WHO guidance advises against co-amoxiclav after preterm prelabor rupture of membranes because the underlying trials found more neonatal necrotizing enterocolitis than with placebo or erythromycin. 3
4. LactMed describes amoxicillin-clavulanate as acceptable during nursing and advises monitoring the infant for restlessness, diarrhea, or rash; published milk measurements primarily quantify amoxicillin rather than clavulanate. 4
5. MotherToBaby reports that one follow-up study of hundreds of children through age 11 did not find learning or behavior differences after pregnancy exposure, but one study cannot exclude uncommon developmental outcomes. 1

Is augmentin safe in each trimester?

• First trimester. Most available first-trimester studies have not found a higher overall rate of major birth differences with amoxicillin-clavulanate, but the combination-specific evidence base is still limited.
• Second trimester. During the second trimester, the reason for the antibiotic and culture results matter more than a blanket label. The prescriber should confirm that Augmentin matches the suspected or identified bacteria.
• Third trimester. Preterm prelabor rupture of membranes is a distinct third-trimester concern. Current WHO guidance advises against co-amoxiclav in that setting because trials found more neonatal necrotizing enterocolitis than with placebo or erythromycin.