Amoxicillin in Pregnancy: Safety Profile (Category B)

FDA Pregnancy Category: B

Animal studies show no fetal risk; no adequate human studies, but extensive post-marketing data support safety.

Key Pharmacologic Points

• Placental transfer: Low — fetal levels ~25–30% maternal
• Teratogenicity: No consistent evidence of structural anomalies
• Fertility: No impairment
• Lactation: Compatible (AAP) — low milk levels

Clinical Use

• First-line for UTIs, GAS pharyngitis, otitis media, sinusitis, LRTI in pregnancy
• Dosage: standard adult doses (renal adjustment if needed)
• Penicillin allergy: assess true allergy (skin testing) — many labeled "allergic" can tolerate

Caveat

Always confirm indication (bacterial vs. viral) and discuss with prescribing clinician.