Which antibiotic is generally considered UNSAFE in pregnancy?

Correct answer: B. Metronidazole

• A. Incorrect. Clindamycin is category B and is the standard alternative for penicillin-allergic pregnant patients.
• B. Per the recall source. Metronidazole is traditionally avoided in the first trimester on theoretical mutagenicity grounds, and is the answer most commonly keyed on board recalls.
• C. Incorrect. Azithromycin is a pregnancy category B macrolide and is considered safe.
• D. Incorrect. Penicillins are the safest antibiotic class in pregnancy.

Note: ⚠️ CONTESTED. Metronidazole is actually FDA category B and current evidence has NOT shown teratogenicity — many sources now consider it acceptable after the first trimester. Note also that ERYTHROMYCIN ESTOLATE is genuinely contraindicated (maternal hepatotoxicity), and TETRACYCLINES are the classic absolute contraindication (tooth discolouration, skeletal effects). Know all three.