Healthcare professionals should keep prescribing macrolides to pregnant women despite the reported links with epilepsy, the MHRA has said.

The medicines watchdog cast doubts over a study by University College London (UCL), which concluded that prescribing this class of antibiotic during pregnancy could carry a “small” increased risk of babies being born with epilepsy or cerebral palsy.

The MHRA stressed the study was “insufficient” to prove any link, as the small numbers and “incomplete data” used meant the results should be treated with “great caution”.

The medicines watchdog had sought “independent expert advice" and decided that it was still “vital” for pregnant women to use antibiotic therapy to treat an infection, it said yesterday (March 25).

Its comments related to a study published in the scientific journal Plos One on the same day, in which UCL researchers reported that, for every 153 women treated with a macrolide instead of a penicillin, there was one additional case of cerebral palsy or epilepsy.

The researchers said their study of nearly 65,000 women prescribed antibiotics during pregnancy found “no overall association between antibiotic prescribing in pregnancy and cerebral palsy or epilepsy in childhood” after taking account of other risk factors.

However, the specific findings about the harmful effects of macrolides added to evidence from several studies conducted over the past 10 years, they said.

The authors called for the use of macrolides in pregnancy to be reviewed by the MHRA and national guidelines to be “reconsidered”. 

The MHRA advised all pregnant women prescribed antibiotics to continue taking them as instructed and to speak to their healthcare professional if they had any questions.

“Infection in pregnancy can cause serious harm, both to the mother and baby, and it is essential that pregnant women continue to receive treatment with an appropriate antibiotic when necessary,” it added.  

What advice will you give to pregnant women on macrolides?

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