Background and Objectives: Antibiotics are the most frequently prescribed drugs in hospitals and their prescription is increased during pregnancy and labor. There are limited data about this issue, and the safe use of antibiotics in pregnancy and antibiotic resistance remains a concern. The aim of the study is to evaluate the use of antibiotics among pregnant women attending hospital for five years. Materials and Methods: Antibiotic consumption and treatment information of patients were retrospectively collected from a hospital software program and expressed as defined daily dose (DDD) according to the World Health Organization (WHO) methodology for inpatients between 2017 and 2021. We evaluated antibiotic prescription by name, classes, and Food and Drug Administration (FDA) categories. Results: Antibiotic consumption shows a decreasing trend between 2017 and 2019, but an increasing one between 2020 and 2021. Ceftriaxone was the most prescribed antibiotic in each year, followed by cefixime, amoxicillin, metronidazole, cefuroxime, ampicillin, and ciprofloxacin. We noticed that first- and fourth-generation cephalosporins were not prescribed to these patients. A very small percentage of women in this study received antibiotics such as aminoglycosides; fluoroquinolones were generally contraindicated in the perinatal period. A large percentage of prescriptions were antibiotics classified as category B by the FDA. The most common infections that occurred in the perinatal period were those of the kidney and urinary tract in a higher number than in other studies. Conclusions: Our study shows that many classes of antibiotics used in perinatal women belong to category B antibiotics, the most prescribed being cephalosporins. Because of insufficient safety evidence and the potential for teratogenic effects on the fetus, restricted use among the category C and D antibiotic classes was seen and anticipated. Improving maternal health requires the involvement of healthcare experts in risk assessment and evaluation of existing data for appropriate antibiotic selection, dose, duration of medication, and monitoring.
Background: Antimicrobial resistance is one of the world’s most serious health issues. Antibiotic resistance, excessive drug expense, and an increased risk of adverse reactions are all common outcomes of incorrect antibiotic prescribing. The goal of this study was to evaluate the prevalence of antibiotic prescriptions for inpatients to find areas for improvement. Methods: A retrospective study at Emergency Clinical County Hospital of Oradea, Romania was performed for five years between 2017 and 2021. Data was collected using medical records of the patients and reports from the pharmacy. Antibiotic consumption was expressed as DDD/100 BD according to the World Health Organization (WHO) by antibiotics, classes, and AWaRe classification. Results: The prevalence of antibiotic prescription was 53.8% during five years evaluated with a significant increase in 2021. A total of 13,677.42 DDD/100 BD antibiotics were prescribed, especially for surgical and medical prophylaxes. The most prescribed antibiotics were ceftriaxone, followed by metronidazole, and cefuroxime but there were some differences between years and wards. The most frequent antibiotic classes prescribed were cephalosporins (43.73%). The use of Watch Group antibiotics was high in all wards (59.69%). Conclusions: The prevalence of antibiotic use was high with cephalosporins being the most prescribed antibiotics. As a result, interventions are required.
The development of microorganism resistance to antibiotics is a topic of global interest and Romania is among the most vulnerable countries in terms of antimicrobial resistance. Our retrospective study was carried out for a year at the Emergency Clinical Hospital for Children "Saint John" in Galati, on a number of 9910 pathological samples. The main isolated strains were Staphylococcus aureus, Escherichia coli, and Klebsiella pneumoniae. A percent of 25.4 was methicillin-resistant Staphylococcus aureus infections and strains displayed high rates of resistance to beta-lactams and macrolides. Less effective for the treatment of infections with Escherichia coli were aminopenicillins and cephalosporins although resistance to third-generation cephalosporins had a relatively small value than the national one. Isolated Escherichia coli strains showed low resistance to fluoroquinolones and aminoglycosides also. Klebsiella sp strains showed increased resistance to third-generation cephalosporins, fluoroquinolones, and aminoglycosides higher than the values recorded at the European level. Results obtained in terms of antibiotic resistance are lower than those recorded in some studies at a national level but higher than the European average. The situation remains worrying if we consider the fact that the selected group is a pediatric one, with most children under nine years. More than ever, we must take active measures in perspective about the seriousness of the problem and the long-term consequences.
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