When treating acute bacterial rhinosinusitis in a pregnant patient, which medication should be avoided?

Acute bacterial rhinosinusitis in pregnant patients requires careful consideration when choosing appropriate medications due to potential risks to the fetus. Levofloxacin, which is a fluoroquinolone antibiotic, is generally avoided during pregnancy. This is primarily because fluoroquinolones have been associated with risks such as cartilage damage in developing joints and potential effects on the fetus's musculoskeletal development.

In contrast, both amoxicillin and azithromycin are often considered safe for use during pregnancy, as they have established safety profiles. Doxycycline, however, is typically avoided in pregnant patients because it can affect the development of teeth and bones in the fetus due to its action as a tetracycline antibiotic. Understanding the safety profiles of these antibiotics is crucial for effective treatment while minimizing risks during pregnancy.