By Amy Morrison | Mom of two, founder of Pregnant Chicken | Researching pregnancy health since 2010 | Last updated: January 2026
Has that thing-that-you-always-get-with-the-problem-that-goes-with-it come back? Wondering if antibiotics are safe during pregnancy? The short answer: Some antibiotics are safe, others aren't, and you absolutely need your doctor to make the call.
The Quick Answer: Yes, But Only Certain Ones
If you have a bacterial infection during pregnancy, it needs to be treated—untreated infections can harm both you and your baby. But not all antibiotics are created equal when you're pregnant.
Safe antibiotics (when prescribed by your doctor):
- Penicillins like amoxicillin and ampicillin
- Cephalosporins like cephalexin
These are typically first-line choices and generally considered safe throughout pregnancy.
Sometimes used, but not first choice:
- Macrolides like erythromycin or azithromycin may be prescribed when needed, but they're not the go-to for every infection. Some research has raised concerns about potential heart rhythm issues or preterm birth, so providers only use them when clearly indicated and safer options won't work.
Antibiotics to avoid:
- Tetracyclines (like doxycycline) - can affect developing bones and teeth
- Aminoglycosides like streptomycin and kanamycin - can damage fetal hearing
- Some fluoroquinolones and high-dose metronidazole early in pregnancy (depending on the situation)
Why You Can't Just Use Leftover Antibiotics
I know the temptation. I've totally been there (cough). But here's why raiding your medicine cabinet for that half-finished antibiotic bottle is especially risky during pregnancy:
The actual risks of self-medicating with old antibiotics:
- You might pick the wrong antibiotic for your current infection
- The dose could be inappropriate for pregnancy
- Incomplete treatment can make infections worse
- You're contributing to antibiotic resistance
- Pregnancy changes how your body processes drugs, making unsupervised dosing dangerous
During pregnancy, even medicines that were previously fine for you can have different effects. Every antibiotic needs to be prescribed and supervised by someone who knows what they're doing.
What About the "Gray Area" Antibiotics?
The reality is that many antibiotics fall somewhere in between "definitely safe" and "definitely avoid." For these, safety depends on:
- The specific dose
- When in pregnancy you'd take it
- Your individual health situation
- Whether safer alternatives exist
This is exactly why you need a healthcare provider making these decisions – they can weigh the benefits against potential risks for your specific case.
When You Actually Need Antibiotics During Pregnancy
If you have a bacterial infection that requires antibiotics, it really does need to be treated. Common infections that need treatment during pregnancy include:
- Urinary tract infections (UTIs)
- Certain respiratory infections
- Specific sexually transmitted infections
- Bacterial skin infections
Here's what to do: Make an appointment and drag yourself (and the thing-that-always-shows-up-with-it) to your provider. Yes, even if you're dealing with the embarrassing recurring issue. They can:
- Confirm you actually have a bacterial infection (not everything needs antibiotics)
- Choose the safest antibiotic for your situation
- Prescribe the correct dose for pregnancy
- Address any related symptoms with pregnancy-safe treatments
The Bottom Line
Don't mess around with antibiotics during pregnancy. If you need them, get them properly prescribed. If you don't need them, don't take them. And for the love of everything, throw out those mystery pills from 2023.
Next steps:
- Call your provider if you have symptoms of infection
- Never self-medicate with leftover antibiotics
- Ask your provider specifically which medications are safe for any recurring issues you tend to get
- Keep a list of medications you've taken during pregnancy for your records
About the Author: Amy Morrison is a mom of two boys and the founder of Pregnant Chicken, where she's been researching and writing about pregnancy and newborn care since 2010. She combines evidence-based information with real-world experience to help parents navigate pregnancy without losing their minds.
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