Pattern of Antibiotic Use in the Perinatal Period in a Public University Hospital in Romania

Abstract

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.

Predictors of antibiotic use in pregnant women attending Najran University Hospital, Saudi Arabia

“…The current study results corroborate with previous studies carried out in Romania and Ghana, which reported beta-lactam antibiotics to be most commonly prescribed antibiotic during pregnancy. 6,13 In the current study, the antimicrobial drugs recommended to the participants were of Food and Drug Administration (FDA) category B (26.4%). Our data did not reveal the presence of any class A or class X antibiotics.…”

Tren Penggunaan Antibiotik dan Profil Resistensi pada Kelompok Critical-Priority Bacteria di ICU Rumah Sakit “X” Provinsi Bali (2017-2019)

“…Data survei yang dilakukan oleh Kementerian Kesehatan Republik Indonesia, pada tahun 2017-2019 pneumonia menjadi salah satu penyakit tiga teratas terbanyak di Indonesia terutama Bali (Kementerian Kesehatan Republik Indonesia, 2020). Namun, pada beberapa negara di Eropa, berdasarkan penelitian yang dilakukan di Rumah Sakit Darurat Klinis negara Rumania pada tahun 2017-2019 dan Klinik Universitas untuk penyakit anak kota Skopje pada tahun 2018-2019 melaporkan bahwa tren penggunaan siprofloksasin mengalami penurunan (Hodoșan et al, 2022;Pechijareva-Sadikarijo et al, 2020). Hal tersebut disebabkan karena pembatasan dalam indikasi kuinolon dan peresepan oleh European Medicinal Agency (EMA) dan Food and Drug Administration (FDA).…”

“…Penelitian yang dilakukan di Klinik Universitas untuk penyakit anak kota Skopje pada tahun 2018-2019 juga menunjukan hasil yang serupa dengan penelitia n ini, terjadi peningkatan penggunaan gentamisin dan amikasin (Pechijareva-Sadikarijo et al, 2020). Namun, penelitian yang dilakukan di Rumah Sakit Darurat Klinis negara Rumania menunjukan hasil yang berbeda, yang mana pada tahun 2017-2019 terjadi penuruna n penggunaan gentamisin dan amikasin (Hodoșan et al, 2022). Perbedaan hasil tren pengguna a n antibiotik antar rumah sakit, daerah, dan juga negara dapat disebabkan karena adanya perbedaan karakteristik pasien, infeksi dan jenis infeksi, populasi pasien, peresepan, resistensi antibiotik, dan kebijakan penggunaan antibiotik yang diterapkan (Amaha et al, 2020;Pechijareva-Sadikarijo et al, 2020).…”

Pattern of Newborn Antibiotic Use in a Tertiary Level Maternity for Five Years

“…The risk increases with every extra day of therapy together with for prophylaxis [22,23]. The side effects of antibiotics given to the mother should also be considered [24]. The care of newborns at risk of developing early infections varies from unit to unit.…”