Bactrim in the second trimester? — The Bump
January 2017 Moms

Bactrim in the second trimester?

Has anyone had to take Bactrim for a uti? My ob prescribed me 1 pill a day for 5 days to treat an asymptomatic uti (asymptomatic bacteriuria?) he instructed I start taking it in July being that I'll officially be over 14 weeks pregnant. I read some things online and it's a category c for pregnancy which seems a little a scary. Should I ask for something else? Anyone expierence this before, this is my 1st pregnancy. 

Re: Bactrim in the second trimester?

  • Usually whenever my doctor has prescribed a class C in pregnancy it's because the benefits of taking it out weight not taking it. But if you are worried I would call your doctor and just explain that you saw it was category C and you wanted to know if he could either prescribe something else or what is reasoning is behind it. 
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  • I have heard of penicillin based drugs or macrobid (non-penicillin) most commonly prescribed for UTIs in pregnancy. Those are class B drugs. Perhaps your doctor has identified the type of bacteria causing your infection and Bactrium is identified as the drug best to fight it? It's worth asking. I would also ask how how he or she determines at what level of bacteria to treat asymptomatic UTIs. Many providers do not treat asymptotic bacteria unless the bacteria count is over a certain level. It's important to treat early in pregnancy obviously, and sometimes asymptomatic bacteria must be treated, but I do believe there is a cut off. 
  • vssbrmvssbrm
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    My OB said the only time she will not back down on prescribed meds is when it comes to an UTI. She said the risks of an unmediated UTI severely out-weigh taking the scripts to get rid of it. I'd call your doc and have him explain his rational. 
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  • Why would your doctor have you wait on starting an antibiotic for a uti? UTIs are dangerous and need to be treated quickly. 
  • He had me on amoxicillin for a week already, he explained to me that Bactrim can mess with folic acid absorption so it's best to take in my second trimester which is the first day of July. 
  • You can absolutely request something else, but like others have said, if you're being prescribed a category c it's because the risks to you not taking it outweigh the risks of taking it to your baby. UTIs can cause a huge slew of scary pregnancy related problems if not treated. 
  • I don't know anything about abx specifically but I'm on Zoloft, have been for a few years and will be through this entire pregnancy. It's a cat C too, but I made a plan with my OB before I got pregnant and we're completely unconcerned. 

    Part of the reason a lot of drugs end up cat C is because there isn't enough reliable data to prove they should be B or so. It's not necessarily because there really is a viable risk, more so because there's no proof of the opposite
  • Just FYI Bactrim is a category D medication in pregnancy but I've seen it prescribed often in the second trimester. It's best to avoid in first trimester and >32 weeks.
    Pregnancy Ticker
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