Do antibiotics interfere with the efficacy of oral contraceptives?

Abstract

Among antibiotics, only rifampin has been demonstrated to interfere with the effectiveness of oral contraceptives (OCs) (strength of recommendation [SOR]: C, limited case series). There is little convincing evidence to show a systematic interaction between other antibiotics and oral contraceptive steroids (SOR: B, based on systematic reviews, case reports, and pharmacologic studies). However, current studies may not have separately evaluated the minority of women whose metabolism of contraceptive steroids makes them more vulnerable to OC failure. Given the significant consequences of unintended pregnancy, some experts recommend a conservative approach, including patient education and backup forms of birth control (SOR: C, expert opinion).