Doxycycline use in early pregnancy associated with higher risk of pregnancy loss

Embargoed for release until 5:00 p.m. ET on Monday 9 November 2026   

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Below please find summaries of new articles that will be published in the next issue of Annals of Internal Medicine. The summaries are not intended to substitute for the full articles as a source of information. This information is under strict embargo and by taking it into possession, media representatives are committing to the terms of the embargo not only on their own behalf, but also on behalf of the organization they represent.   
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Doxycycline use in early pregnancy associated with higher risk of pregnancy loss

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-26-01647

URL goes live when the embargo lifts             

A retrospective, active-comparator cohort study found that doxycycline use for respiratory tract infections or acne during early pregnancy was associated with an increased risk for pregnancy loss. Given the frequent use of doxycycline by women of childbearing age, these findings underscore the importance of both clinicians and patients weighing the benefits and risks when considering treatment with doxycycline. The findings are published in Annals of Internal Medicine.

Doxycycline is a commonly used antibiotic that is prescribed to treat a variety of infections, including skin and respiratory tract infections. Researchers from the University of Florida and colleagues analyzed insurance claims data from commercial and Medicaid databases of 218,234 pregnancies from women with respiratory tract infections and 6,636 pregnancies from women with acne to assess whether taking doxycycline during early pregnancy was associated with pregnancy loss. They compared women who filled prescriptions for doxycycline during the first trimester with similar women who received alternative treatments, including amoxicillin and macrolide for respiratory tract infections and topical clindamycin for acne. In both insurance claims databases, there was a higher risk for pregnancy loss among women with respiratory tract infections who used doxycycline. In patients with acne, risk was higher in pregnancies with doxycycline exposure in the commercial claims database, but not in Medicaid. The findings provide additional data to inform clinical recommendations for the treatment and postexposure prophylaxis of infections during pregnancy.

Media contacts: For an embargoed PDF, please contact Gabby Macrina at gmacrina@acponline.org. To contact corresponding author Almut G. Winterstein, PharmD, PhD, please email Matt Splett at msplett@ufl.edu.  

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