Prescribing in Pregnancy — ORE Part 1 MCQ

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EasyPharmacology & TherapeuticsPrescribing in PregnancyORE Part 1

A 30-year-old woman is 16 weeks pregnant and presents with a dental abscess. She requires antibiotic therapy. Which of the following antibiotics is considered safe in pregnancy?

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Correct answer: E — Amoxicillin

Explanation lettering: B = shown as A · D = shown as B · E = shown as D · A = shown as E

Amoxicillin (A) is the correct answer. UK authoritative sources confirm amoxicillin is safe in pregnancy: the eMC SmPC states 'limited data do not indicate increased risk of congenital malformations,' and the NHS confirms 'it is safe to take amoxicillin during pregnancy.' It is effective for dental infections and represents an appropriate second-line penicillin choice (after phenoxymethylpenicillin). Doxycycline (C) is contraindicated in the second trimester due to effects on fetal bone and dental development. Clarithromycin (D) carries residual uncertainty; UK government review concluded available evidence is insufficient to exclude small increased risks of malformations in early pregnancy. Metronidazole (B) and ciprofloxacin (E), while sometimes used for specific odontogenic infections, lack the clear safety endorsement afforded amoxicillin for routine use in pregnancy. At 16 weeks gestation, the woman is in the second trimester, past the critical organogenesis period, and amoxicillin is the safest, evidence-backed choice.

Reference: Medicines and Healthcare products Regulatory Agency (MHRA). Amoxicillin 500mg Capsules – Summary of Product Characteristics. medicines.org.uk; NHS. Pregnancy, breastfeeding and fertility while taking amoxicillin. NHS.uk. https://www.medicines.org.uk/emc/product/526/smpc