Dermatology and Pathology, Rutgers New Jersey Medical School, Newark, NJ, USA.
J Eur Acad Dermatol Venereol. 2017 Sep;31(9):1440-1446. doi: 10.1111/jdv.14297. Epub 2017 Aug 4.
Medications should be employed with caution in women of childbearing age who are pregnant or considering pregnancy. Compared to oral or parenteral agents, topical medications have limited systemic absorption and are deemed safer. However, their safety profile must be assessed cautiously due to the limited available data. In this article, we aggregate human and animal studies to provide recommendations on utilizing topical antiviral and antifungal medications in pregnancy. For antiviral medications, acyclovir and trichloroacetic acid are safe to use in pregnancy. Docosanol, imiquimod and penciclovir are likely safe, but should be utilized as second-line agents. Podofilox and podophyllin resin should be avoided. For antifungal medications, clotrimazole, miconazole and nystatin are considered first-line agents. Butenafine, ciclopirox, naftifine, oxiconazole and terbinafine may be utilized after the above agents. Econazole should be avoided during the first trimester and used sparingly during 2nd and 3rd trimester. Ketoconazole and selenium sulphide are likely safe, but should be employed in limited areas for brief periods.
药物应谨慎用于有生育能力且怀孕或考虑怀孕的女性。与口服或肠胃外药物相比，局部药物全身吸收有限，被认为更安全。然而，由于可用数据有限，必须谨慎评估其安全性。在本文中，我们汇总了人体和动物研究结果，为妊娠期间使用局部抗病毒和抗真菌药物提供建议。对于抗病毒药物，阿昔洛韦和三氯乙酸在怀孕期间使用是安全的。二十二烷醇、咪喹莫特和喷昔洛韦可能安全，但应作为二线药物使用。鬼臼毒素和鬼臼毒素树脂应避免使用。对于抗真菌药物，克霉唑、咪康唑和制霉菌素被认为是一线药物。但在上述药物之后可以使用布替萘芬、环吡酮、萘替芬、酮康唑和特比萘芬。在怀孕初期应避免使用益康唑，在怀孕 2 至 3 期应慎用。酮康唑和硫化硒可能安全，但应在有限区域短时间内使用。
