Evidence-based antimicrobial therapy in pregnancy: long overdue.

Little evidence exists to guide the clinician caring for pregnant patients with infectious morbidities. The already-small pool of evidence shrinks rapidly as the pathogen becomes more exotic, making therapeutic decisions increasingly speculative when emerging infectious diseases appear in the pregnant patient. The current drug approval mechanisms, legal environment, and profit-driven drug pipeline have combined to exclude pregnant women from clinical trials, paradoxically resulting in a dangerous situation for pregnant women around the world.