Drugs in Pregnancy

Al-Zidan, Radhwan Nidal

doi:10.1201/9781003019107

Cited by 2 publications

(6 citation statements)

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“…Evidence of effects of ornidazole on fetus from human studies is limited. Fetal risks of other nitroimidazoles are diverse, with metronidazole being classified as category B and tinidazole as category C due to limited evidence from human pregnancy studies [ 1 , 12 ]. Therefore, ornidazole should be used similar to tinidazole, which is recommended for use only if metronidazole fails to eradicate the infection [ 12 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the complexity of drug use during pregnancy cannot be sufficiently addressed using such a simple system [ 8 ]. This system has been widely criticized for its oversimplification and incompetence to guide clinical practice and thus, it was replaced by a new narrative labelling system in 2015 [ 8 , 12 ]. Our results of antibiotic prescription patterns based on FDA pregnancy categories can only provide a rough description of fetal-risk considerations of antibiotic prescriptions during pregnancy.…”

Section: Discussionmentioning

confidence: 99%

“…To assess whether potential teratogenic risk and fetal harm were considered when prescribing antibiotics for pregnant women, we classified the antibiotics into categories B, C and D by following the FDA letter categorization system [ 1 , 12 , 17 , 18 ]. Antibiotics that had not been assigned to any FDA category were classified as category N in this study [ 12 ]. All antibiotics prescribed for pregnant women and the categories in this study are presented in the Table S3 in the Supplementary Materials .…”

Section: Methodsmentioning

confidence: 99%

“…As a response to the concern of embryo–fetal risk of drugs used during pregnancy, numerous classification systems have been adopted in different countries for labelling drug safety. The most commonly used classification system is the United States Food and Drug Administration (FDA) letter categorization system [ 12 ], which classifies drugs into five categories—A, B, C, D and X—according to potential fetal risks, based on the findings of human and animal studies [ 1 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Antibiotic Prescriptions among China Ambulatory Care Visits of Pregnant Women: A Nationwide Cross-Sectional Study

et al. 2021

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Background: Antibiotic use in pregnant women at the national level has rarely been reported in China. Objectives: We aimed to investigate antibiotic prescriptions during pregnancy in ambulatory care settings in China. Methods: Data of 4,574,961 ambulatory care visits of pregnant women from October 2014 to April 2018 were analyzed. Percentages of Antibiotic prescriptions by different subgroups and various diagnosis categories and proportions of inappropriate antibiotic prescriptions for different subgroups were estimated. Food and Drug Administration (FDA) pregnancy categories were used to describe the antibiotic prescription patterns. The 95% confidence intervals (CIs) were estimated using the Clopper––Pearson method or Goodman method. Results: Among the 4,574,961 outpatient visits during pregnancy, 2.0% (92,514 visits; 95% CI, 2.0–2.0%) were prescribed at least one antibiotic. The percentage of antibiotic prescriptions for pregnant women aged >40 years was 4.9% (95% CI, 4.7–5.0%), whereas that for pregnant women aged 26–30 years was 1.5% (95% CI, 1.4–1.5%). In addition, percentages of antibiotic prescriptions varied among different trimesters of pregnancy, which were 5.4% (95% CI, 5.3–5.4%) for the visits in the first trimester of pregnancy and 0.5% (95% CI, 0.4–0.5%) in the third trimester of pregnancy. Furthermore, the percentages of antibiotic prescriptions substantially varied among different diagnosis categories and nearly three-quarters of antibiotic prescriptions had no clear indications and thus might be inappropriate. In total, 130,308 individual antibiotics were prescribed; among these, 60.4% (95% CI, 60.0–60.8%) belonged to FDA category B, 2.7% (95% CI, 2.1–3.5%) were classified as FDA category D and 16.8% (95% CI, 16.2–17.4%) were not assigned any FDA pregnancy category. Conclusions: Antibiotic prescriptions in ambulatory care during pregnancy were not highly prevalent in mainland China. However, a substantial proportion of antibiotics might have been prescribed without adequate indications. Antibiotics whose fetal safety has not been sufficiently illustrated were widely used in pregnant women.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Antibiotic Prescriptions among China Ambulatory Care Visits of Pregnant Women: A Nationwide Cross-Sectional Study

et al. 2021

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“…63 Salah satu pilihan antibiotik adalah ceftriaxone 1 x 2 g. 64 Status FDA ceftriaxone kategori B dalam kehamilan. [65][66][67][68] Antibiotik ini juga disarankan pada koeksistensi pneumonia dan ISK pada asma dengan kehamilan. [65][66][67][68] Pilihan antibiotik harus disesuaikan dengan pola resistensi kuman lokal.…”

Section: Kelas Obatunclassified

Manajemen Asma dalam Kehamilan: Apa yang Harus Dipahami oleh Dokter Umum

Habiburrahman

Rakasiwi

2023

Cermin Dunia Kedokteran

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Eksaserbasi asma dalam kehamilan dapat mempersulit proses persalinan dan berisiko bayi lahir dengan berat badan lahir rendah dan ibu berisiko mengalami persalinan preterm, preeklampsia, dan sectio caessaria. Penyebab eksaserbasi asma dalam kehamilan dapat akibat terapi kurang optimal selama kehamilan akibat kekhawatiran personal pasien dan dokter yang kurang didukung bukti terkait keamanan agen farmakologis asma dalam kehamilan, dan rendahnya kepatuhan pasien untuk kontrol rutin, terutama selama masa pandemi COVID-19. Hingga kini, manajemen asma antenatal menjadi tugas besar dokter umum di layanan primer, dan dokter spesialis obstetrik dan ginekologi, serta dokter spesialis paru di layanan sekunder, sedangkan panduan khusus komprehensif asma dalam kehamilan di Indonesia masih terbatas. Telaah literatur ini bertujuan untuk memberikan pemahaman esensial perubahan klinis dan mekanisme yang berkontribusi terhadap tidak terkontrolnya asma selama kehamilan, pendekatan diagnosis komprehensif asma dalam kehamilan, dan menyediakan informasi obat-obatan yang aman untuk manajemen asma dalam kehamilan. Asthma exacerbations in pregnancy can complicate the delivery process and risk low birth weight in the baby, as well as preterm labor, preeclampsia, and a cesarean section in mothers. Asthma exacerbations during pregnancy can be caused by ineffective treatment due to patient and physician concerns about the safety of asthma medications during pregnancy that are not supported by reliable data, as well as poor patient compliance for routine control, particularly during the COVID-19 pandemic. Asthma management during antenatal care falls primarily on general practitioners in primary care, and obstetricians and gynecologists, and pulmonologists in secondary-level services. While specific guidelines in Indonesia are still limited, this review aims to present a fundamental understanding of clinical changes and mechanisms that contribute to the uncontrolled status of asthma during pregnancy, a comprehensive diagnostic approach to asthma in pregnancy, and provide a safety drug profile during pregnancy

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Drugs in Pregnancy

Cited by 2 publications

References 0 publications

Antibiotic Prescriptions among China Ambulatory Care Visits of Pregnant Women: A Nationwide Cross-Sectional Study

Antibiotic Prescriptions among China Ambulatory Care Visits of Pregnant Women: A Nationwide Cross-Sectional Study

Manajemen Asma dalam Kehamilan: Apa yang Harus Dipahami oleh Dokter Umum

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