From the Guidelines
Augmentin (amoxicillin/clavulanic acid) is considered compatible for use during pregnancy, but its use should be carefully weighed against potential risks, particularly in women at risk of pre-term delivery, due to a very low risk of necrotising enterocolitis in the fetus 1. When considering the treatment of periodontitis in pregnant women, it's crucial to balance the benefits of treating the infection against the potential risks associated with antibiotic use.
- Non-antibiotic approaches, such as professional dental cleaning, should be the first line of treatment.
- If antibiotics are necessary, Augmentin (amoxicillin/clavulanic acid) can be considered, given its classification as FDA pregnancy category B, indicating that while there are no adequate well-controlled studies in pregnant women, animal studies have not shown a risk to the fetus 1.
- The typical dosing for Augmentin in this context would be 500/125 mg three times daily for 7-10 days, though this may be adjusted based on the individual's specific situation.
- It's essential for pregnant women to inform both their dentist and obstetrician about their pregnancy before any treatment and to discuss alternative antibiotics if they have a penicillin allergy.
- Regular dental checkups during pregnancy are recommended to prevent the need for antibiotics and to monitor oral health.
- The benefits of treating active periodontal infection during pregnancy often outweigh the potential risks, as untreated gum disease has been associated with adverse pregnancy outcomes, including preterm birth and low birth weight. Given the information from the study 1, it's clear that while Augmentin can be used during pregnancy, its use must be approached with caution, especially in certain high-risk groups, and under the guidance of healthcare providers.
From the Research
Periodontitis and Pregnancy
- Periodontal disease is an inflammatory disease of the tissues supporting the teeth, affecting 65 million adults over the age of 30 years in the USA, and worldwide 5 to 70% of adults 2.
- Women who develop periodontal disease during pregnancy may have a higher risk of adverse pregnancy outcomes, with periodontal disease being moderate in 18.3% of pregnant women 3.
- The relationship between periodontal disease during pregnancy and adverse pregnancy outcomes is less substantiated, due to conflicting evidence 4.
Treatment of Periodontal Disease During Pregnancy
- A randomized controlled trial found that treating periodontal disease during pregnancy does not prevent preterm birth, fetal growth restriction, or preeclampsia, but periodontal treatment was not hazardous to the women or their pregnancies 5.
- Periodontal treatment was highly successful in improving the health of the gums, with no differences between the control and treatment groups in preterm birth, birth weight, preeclampsia, or other obstetric endpoints 5.
Augmentin Safety for Pregnancy
- There is no direct evidence in the provided studies regarding the safety of Augmentin for pregnancy in the context of periodontitis.
- However, the studies suggest that periodontal disease treatment during pregnancy is not hazardous to the women or their pregnancies, but the specific safety of Augmentin is not mentioned 5, 6.
Periodontal Disease and Adverse Pregnancy Outcomes
- Systematic reviews have found consistent evidence that pregnant women with periodontal disease are at increased risk of developing preeclampsia and delivering a preterm and/or low birth weight baby 6.
- The estimated population-attributable fractions for periodontal disease were 5% to 38% for preterm birth, 6% to 41% for low birth weight, and 10% to 55% for preeclampsia 6.