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Trimethoprim in pregnancy — GPhC CRA MCQ

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ModerateInfectionsTrimethoprim in pregnancyGPhC CRA

A 9-week pregnant patient presents a prescription for trimethoprim 200 mg twice daily for 3 days for cystitis. She takes folic acid 400 micrograms daily and has no culture result yet. She asks whether it is safe. What is the most appropriate action?

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Correct answer: B — Query the prescription because early pregnancy makes trimethoprim less suitable

Trimethoprim is a folate antagonist and is generally avoided in the first trimester where possible. The pharmacist should query the prescription and consider pregnancy-appropriate antibiotic guidance. Dose changes should not be made independently. Stopping folic acid would be inappropriate.

Reference: BNF; NICE CKS