Valent Francesca, Gongolo Francesco, Deroma Laura, Zanier Loris
Planning and Programming Area, Central Health Directorate, Friuli Venezia Giulia Region , Udine , Italy .
J Matern Fetal Neonatal Med. 2015 Jan;28(2):210-5. doi: 10.3109/14767058.2014.906572. Epub 2014 Apr 25.
To investigate the prescriptions of systemic antibiotics in a population of pregnant women in Italy, to identify socio-demographic factors associated with increased risk of being prescribed potentially unsafe medications, to compare prescriptions before and during pregnancy and to identify the prescribing General Practitioners (GPs).
A retrospective study based on administrative anonymous databases included all women resident of the Friuli Venezia Giulia Region who delivered babies in 2011 (n=9196). The antibiotic prescription risk was calculated by trimester and overall, and compared with that in the year before. Multivariate logistic regression analyses assessed the role of socio-demographic factors on the risk of being prescribed medications that should not be used as first-line.
6688 women (72.7%) were prescribed medicines (27363 prescriptions) during their pregnancies. Antibiotics were prescribed to 2279 women (24.8%), less commonly during pregnancy than before. Prescriptions were more frequent in the second and third trimesters. 1736 women were prescribed antibiotics other than first-line medicines (of which, seven tetracyclines and 58 quinolones, which are frankly not recommended). Those women were more frequently younger and less educated. The GPs responsible for those prescriptions were identified.
In order to improve the prescription of antibiotics in pregnancy, an audit with the GPs is warranted to understand their motivations, discuss clinical cases and build consensus guidelines on which antibiotics should be preferred for use in pregnancy.
调查意大利孕妇群体中全身用抗生素的处方情况,确定与开具潜在不安全药物风险增加相关的社会人口学因素,比较妊娠前和妊娠期的处方情况,并确定开具处方的全科医生(GP)。
一项基于匿名行政数据库的回顾性研究纳入了2011年在弗留利-威尼斯朱利亚大区分娩的所有女性居民(n = 9196)。按孕期和总体计算抗生素处方风险,并与前一年进行比较。多变量逻辑回归分析评估了社会人口学因素对开具不应作为一线用药的药物风险的作用。
6688名女性(72.7%)在孕期开具了药物(27363张处方)。2279名女性(24.8%)开具了抗生素,孕期开具抗生素的情况比之前少见。处方在妊娠中期和晚期更为频繁。1736名女性开具了非一线药物的抗生素(其中,7例为四环素类,58例为喹诺酮类,这些药物明确不推荐使用)。这些女性更年轻且受教育程度更低。确定了负责这些处方的全科医生。
为了改善孕期抗生素的处方情况,有必要与全科医生进行审核,以了解他们的用药动机,讨论临床病例,并就孕期优先使用哪些抗生素制定共识指南。