Can You Take Bactrim While Pregnant?

Written by: Jessica Guht
Jessica Guht
Categorized as Antibiotics
Created on:
Jessica Guht
Categorized as Antibiotics

No one likes getting sick, but it can be even more concerning if a woman gets sick while they are pregnant, as they then have to wonder if the medication they are prescribed is safe for them and their baby. 

Bactrim is an antibiotic often prescribed, especially for UTIs, but is it safe to take Bactrim while pregnant? The general consensus is that it should be avoided during the first trimester because of possible risks, although a folic acid supplement may help mitigate them. 

Continue reading to learn more about how Bactrim can affect a pregnant woman and some other antibiotics to avoid during pregnancy.

Table of Contents

About Bactrim

Bactrim is a combination antibiotic that contains the medications trimethoprim and sulfamethoxazole. Individually, they treat their own sets of bacterial strains, but when combined, they can fight a broader range of infections. 

Bactrim fights bacterial infections by interfering with bacterial protein production—trimethoprim and sulfamethoxazole block two steps in the production of nucleic acid and proteins needed by bacteria in order to survive. 


Bactrim may be prescribed to treat: 

As an antibiotic, though, Bactrim is only effective if the above conditions are due to a bacterial infection. For example, ear infections can be viral or bacterial infections, but Bactrim would only be an effective treatment if bacteria cause it. 

Side Effects

Those who take Bactrim may notice some common and mild symptoms, but some more severe side effects can also manifest. 

Like most antibiotics, Bactrim’s most common side effects include nausea, vomiting, stomach pain, and diarrhea. Taking Bactrim with food and staying hydrated can help to combat these side effects.

Those who take Bactrim also have to be careful about time spent in the sun, as Bactrim can make your skin more sensitive, increasing your risk of sunburn. If you’re taking Bactrim, try to avoid sunlight when you can, and wear protective clothing and sunscreen if you have to go outside. 

Bactrim may also cause an allergic reaction in some people, with symptoms that include:

  • hives
  • coughing
  • shortness of breath
  • swelling in the throat, mouth, or face
  • chest pain

Severe skin reaction is another possible side effect, manifesting as a red or purple rash with peeling skin, blistering, and eye pain. If you experience these symptoms, or those of an allergic reaction, seek immediate medical attention. 

The final side effect to be aware of concerning Bactrim is that it can cause liver problems in some people. If you notice urine darkening, stool lightening, or yellowing of your skin or eyes, contact your doctor. 

Can You Take Bactrim While Pregnant?

Bactrim is not often a first-choice antibiotic for those who are pregnant because of potential concerns regarding its impact on fetal development. Still, if the benefits offered by Bactrim outweigh the potential risks, someone may still be prescribed Bactrim. 

Is Bactrim Safe to Take While Pregnant?

It is recommended to avoid Bactrim, when possible, during the first trimester of pregnancy. This is because it has displayed antifolate effects that can then lead to neural tube defects, urinary tract defects, cardiovascular abnormalities, club foot, and oral clefts. However, the studies with these findings notably include only a small number of exposed cases and also contain selection and information biases. 

Other sources have stated that if Bactrim does increase the risk of birth defects when taken during pregnancy, this risk appears to be small. For example, one study gave mothers Bactrim or a placebo. The results showed congenital abnormalities in 3 of the 66 patients receiving a placebo and 4 of the 120 patients using Bactrim. 

So, it is often recommended to avoid Bactrim during the first trimester, but studies show that, if it is taken, the associated risk may be very minimal. 

There are also some authorities who do not recommend its use in late pregnancy, specifically in the time right before delivery. 

Possible Side Effects of Taking Bactrim While Pregnant

Bactrim does not appear to make any side effects for pregnant women worse beyond the general side effects that those on Bactrim experience. 

However, Bactrim can affect your levels of folic acid, which is crucial for the baby’s development, especially within the first trimester. Low folic acid levels can increase the risks of heart defects, cleft lip or palate, urinary tract defects, and neural tube defects. 

Some doctors, to help combat the lowering of folic acid, may prescribe you a high dose of folic acid to take alongside Bactrim, which can help keep your folic acid levels within a suitable range and still allow you to benefit from Bactrim’s bacteria-fighting abilities.

Which Antibiotics Are Safe to Take While Pregnant?

Some antibiotics which are generally considered safe to take during pregnancy include:

  • penicillins (e.g., amoxicillin, ampicillin)
  • cephalosporins (e.g., cephalexin and cephaclor)
  • clindamycin

Of course, your doctor will be able to provide you with the safest antibiotic for you to take during the duration of your pregnancy. 

What Antibiotics Should Be Avoided in Pregnancy?

In addition to Bactrim, there are other antibiotics that should be avoided during pregnancy. 

For example, tetracyclines can affect the baby’s bone development, which is why they are not recommended for mothers after their fifth week of pregnancy. 

Streptomycin and kanamycin should also be avoided during pregnancy as they can cause hearing loss. 

In addition to these specific types of antibiotics, it is also recommended to opt for narrow-spectrum antibiotics, when possible, instead of broad-spectrum antibiotics, as research has shown that fetuses exposed to broad-spectrum antibiotics have a significantly higher risk of cerebral palsy. 

When to See a Doctor?

If you’re ever feeling under the weather while pregnant, it’s best to speak to your doctor as soon as you are able so that they can work on treating your symptoms and getting you feeling better. This is especially important for pregnant women, as any illness affects not only you but your growing baby. 

With DrHouse, you can meet with an online doctor in just 15 minutes to discuss your symptoms and receive an antibiotic prescription online. If you are ever concerned about the safety of your medication, don’t be afraid to ask your doctor if it is safe for a pregnant woman to take. 

Key Takeaways

Women who are pregnant have to be aware of a whole host of things that are not safe for them to take, and that includes antibiotics. Bactrim, in particular, is an antibiotic often prescribed, especially for UTIs, which pregnant women are more susceptible to. While some sources say Bactrim is safe to take while pregnant, others recommend against it. 

This is because Bactrim, when taken during the first trimester and around the time of delivery, can lower the amount of folic acid a woman produces, which can lead to birth defects such as heart conditions, cleft lips, and neural tube defects. However, if it is determined that the benefits offered by Bactrim outweigh these potential risks, a doctor may have a woman take a high-dose folic acid supplement to counteract the effects of Bactrim. 

Ultimately, it is up to a woman and her doctor to decide which antibiotic is best for her infection, and other options may be deemed safer for her to take while she is with child. Any woman concerned about a drug’s safety should check with her doctor. 


Content on the DrHouse website is written by our medical content team and reviewed by qualified MDs, PhDs, NPs, and PharmDs. We follow strict content creation guidelines to ensure accurate medical information. However, this content is for informational purposes only and not a substitute for professional medical advice, diagnosis, or treatment. For more information click here.

Always consult with your physician or other qualified health providers about medical concerns. Never disregard professional medical advice or delay seeking it based on what you read on this website.

If you are experiencing high fever (>103F/39.4C), shortness of breath, difficulty breathing, chest pain, heart palpitations, abnormal bruising, abnormal bleeding, extreme fatigue, dizziness, new weakness or paralysis, difficulty with speech, confusion, extreme pain in any body part, or inability to remain hydrated or keep down fluids or feel you may have any other life-threatening condition, please go to the emergency department or call 911 immediately.

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