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Metronidazole, sold under the brand name Flagyl among others, is an antibiotic and antiprotozoal medication. [10] It is used either alone or with other antibiotics to treat pelvic inflammatory disease , endocarditis , and bacterial vaginosis . [ 10 ]
Women should speak to their doctor or healthcare professional before starting or stopping any medications while pregnant. [1] Drugs taken in pregnancy including over-the counter-medications, prescription medications, nutritional supplements, recreational drugs, and illicit drugs may cause harm to the mother or the unborn child.
Treatment for both pregnant and non-pregnant women is usually with metronidazole, [32] by mouth once. [31] Caution should be used in pregnancy, especially in the first trimester. [33] Sexual partners, even if they have no symptoms, should also be treated. [23] Single oral dose of nitroimidazole is sufficient to kill the parasites. [34]
Topical clotrimazole is categorized as pregnancy category B. [15] Small amounts of clotrimazole may be absorbed systemically following topical and vaginal administration. However, topical clotrimazole is still considered safe to use to treat yeast infections in pregnant women and is a safer alternative to other antifungals. [15] [16]
The pregnancy category of a medication is an assessment of the risk of fetal injury due to the pharmaceutical, if it is used as directed by the mother during pregnancy.It does not include any risks conferred by pharmaceutical agents or their metabolites in breast milk.
A sensitive serum pregnancy test is typically obtained to rule out ectopic pregnancy. Culdocentesis will differentiate hemoperitoneum (ruptured ectopic pregnancy or hemorrhagic cyst) from pelvic sepsis (salpingitis, ruptured pelvic abscess, or ruptured appendix). [28] Pelvic and vaginal ultrasounds are helpful in the diagnosis of PID.
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For people who are symptomatic, it is used after treatment with metronidazole or tinidazole. [2] It is taken by mouth. [1] Diloxanide generally has mild side effects. [3] Side effects may include flatulence, vomiting, and itchiness. [1] During pregnancy it is recommended that it be taken after the first trimester. [1]
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