Pregnancy, Patiente and aerosoltherapy

Question

Hello,
I suffer from CF and in the second months of pregnancy. Can I continune my aerosol therapy with rhDNAse (Pulmozyme), colistin and tobramycin? What about the oral antibiotics (azithromycin etc)? Or what about potentailly necessary i.v. therapies? Is this without danger for my baby?

Many thanks for your advice.

Answer

Dear questioner

In a CF patient, inhaled treatments (pulmozyme, colistin, tobramycin ...) and azithromycin during pregnancy are usually continued. The passage of inhaled drugs into the blood is not zero but the blood concentration is much lower than when administered orally or intravenously.

The purpose of these inhaled treatments is to allow good respiratory status during pregnancy and to avoid antibiotics as much as possible. The risk of i.v. therapy is greater if you stop these aerosols.

Nevertheless, if your doctor judges at any time of your pregnancy that you need an i.v. antibiotic treatment, he will choose the antibiotics compatible with your pregnancy and it will be necessary to do this treatment because if the mother isn't doing well during the pregnancy, the baby will not be doing well either...

On the other hand, vitamin A, which is considered to be teratogenic, is often stopped.

Best regards,
Dr Isabelle Danner (CHU Nantes)

13.04.2017