Różańska Anna, Pac Agnieszka, Jachowicz Estera, Jaślan Dorota, Siewierska Małgorzata, Wójkowska-Mach Jadwiga
Microbiology, Jagiellonian University Medical College, 31-121 Kraków, Poland.
Department of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, 31-121 Kraków, Poland.
Antibiotics (Basel). 2020 Dec 26;10(1):14. doi: 10.3390/antibiotics10010014.
excessive and incorrect use of antibiotics is a common event that contributes to increased bacterial resistance to antibiotics. Based on the European Centre for Disease Control and Prevention (ECDC) European Surveillance of Antimicrobial Consumption (ESAC)-Net reports, outpatient antibiotics prescribing in Poland, is higher than the European average rate. However, ECDC reports do not provide data on consumption in specific patient groups. Additional studies focused on selected patient groups are needed for a more detailed analysis. The use of antibiotics during pregnancy is inevitable due to the proven risk of complications in this period, perinatal infections, and infections in newborns, in the situation of frequent infections of the genital tract, urinary tract, and asymptomatic bacteriuria in pregnant women. The aim of this study was to analyze the use of antibiotics/the implementation of antibiotic prescriptions ordered by gynecologists during pregnancy in pregnant women in Małopolska Voivodeship, with particular emphasis on demographic data and drug groups.
the analysis used data on the reimbursement of antibiotics from the Małopolska Health Fund for 2013-2014. The database contained information of a demographic nature: age, place of residence, date of birth, as well as information on the type of drug, and the number of packages purchased by the patients.
the study included 67,917 women. During pregnancy, 23.6% filled their prescriptions for antibiotics. In the first trimester, the percentage of women filling their prescriptions for antibiotics was the lowest and amounted to 7.8%, in the second and third trimesters, these were 9.0% and 11.2%, respectively. The inhabitants of rural areas bought antibiotics more often (23.5%). Most frequently, antibiotics were purchased by women under 18 years of age (32.1%), but the use of antibiotics in women aged 18-34 and over 35 was similar, amounting to 23.8% and 22.7%, respectively. Most often (94.78% of cases) monotherapy was used, including beta-lactams and beta-lactams with an inhibitor (67.3%), then second-generation cephalosporins (13.5%), macrolides (14.73%), and others. Prescription of two different preparations was found in 5.06% of cases, three (0.19%), and four or more (0.03%).
due to the fact that studies on antibiotic therapy in pregnant women in Poland are rare, it is impossible to assess the situation thoroughly. Additionally, in Poland, the prevalence of gestational infections is unknown, and their diagnostics is important, especially in relation to microbiological diagnostics and targeted treatment. However, the present results indicate the need to implement broad health promotion programs, accessible to all women, also those living outside large cities, particularly promoting the prevention of urinary tract infections and reproductive health in general.
抗生素的过度及不当使用是导致细菌对抗生素耐药性增加的常见原因。根据欧洲疾病预防控制中心（ECDC）的欧洲抗菌药物消费监测（ESAC）-Net报告，波兰门诊抗生素处方率高于欧洲平均水平。然而，ECDC报告未提供特定患者群体的消费数据。需要针对选定患者群体开展更多研究以进行更详细的分析。鉴于孕期并发症、围产期感染以及新生儿感染的风险已得到证实，且孕妇生殖道、泌尿道频繁感染及无症状菌尿的情况较为常见，孕期使用抗生素不可避免。本研究旨在分析波兰小波兰省孕妇孕期抗生素的使用情况/妇科医生开具的抗生素处方执行情况，特别关注人口统计学数据和药物类别。
分析采用了2013 - 2014年波兰小波兰省卫生基金抗生素报销数据。该数据库包含人口统计学信息：年龄、居住地点、出生日期，以及药物类型和患者购买包装数量的信息。
该研究纳入了67917名女性。孕期有23.6%的女性填写了抗生素处方。在孕早期，填写抗生素处方的女性比例最低，为7.8%，孕中期和孕晚期分别为9.0%和11.2%。农村地区居民购买抗生素的频率更高（23.5%）。18岁以下女性购买抗生素最为频繁（32.1%），但18 - 34岁和35岁以上女性的抗生素使用情况相似，分别为23.8%和22.7%。大多数情况（94.78%的病例）采用单一疗法，包括β-内酰胺类和含抑制剂的β-内酰胺类（67.3%），其次是第二代头孢菌素（13.5%）、大环内酯类（14.73%）及其他。5.06%的病例开具了两种不同制剂的处方，0.19%开具了三种，0.03%开具了四种或更多。
由于波兰关于孕妇抗生素治疗的研究较少，无法全面评估情况。此外，波兰孕期感染的患病率未知，其诊断很重要，尤其是微生物诊断和针对性治疗方面。然而，目前的结果表明需要实施面向所有女性的广泛健康促进项目，包括大城市以外地区的女性，特别是总体上促进预防泌尿道感染和生殖健康。
