Paper II — 2017 August (Supplementary) (2010 Scheme) — Q2
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Paper II
2017 August (Supplementary) (2010 Scheme) · 40 marks · 120 min
Question
A 20 years old pregnant women developed a mild bacterial upper respiratory tract
infection. She was given cap. tetracycline 250 mg thrice daily for 3 days. Answer the
following questions:
(a) Comment on the treatment for a mild bacterial infection 2 mark(s)
(b) Comment on the use of tetracycline in pregnancy 2 mark(s)
(c) If it were a severe infection what would be the choice of antibiotic in a pregnant 2 mark(s)
Q26 marksEssays
Answer
(a) Comment on the treatment
Most mild upper respiratory tract infections are viral and self-limiting, not requiring antibiotics
Even if bacterial, a narrow-spectrum, pregnancy-safe antibiotic at the correct dose/duration should be chosen
Prescribing tetracycline here is a clear prescribing error, since it is contraindicated in pregnancy regardless of whether antibiotic therapy was indicated at all
(b) Use of tetracycline in pregnancy
Contraindicated. Tetracyclines cross the placenta and are deposited in developing fetal bones and teeth (calcium chelation), causing discolouration/staining of deciduous teeth and inhibition of fetal bone growth
Also hepatotoxic to the mother, particularly with high IV doses
(c) Choice for a severe infection in pregnancy
Penicillins (e.g., Amoxicillin) — first choice, safe in pregnancy
Cephalosporins or Erythromycin (macrolide) as alternatives, especially in penicillin allergy
Avoid tetracyclines, fluoroquinolones, and aminoglycosides in pregnancy unless specifically indicated and unavoidable
