Faculty of Medicine and Pharmacy, Doctoral School of Biomedical Sciences, University of Oradea, 1 University Street, 410087 Oradea, Romania.
Psycho-Neurosciences and Recovery Department, Faculty of Medicine and Pharmacy, University of Oradea, 1 University Street, 410087 Oradea, Romania.
Medicina (Kaunas). 2022 Jun 7;58(6):772. doi: 10.3390/medicina58060772.
: 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. : 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. : 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. : 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.
抗生素是医院最常开的药物，在怀孕期间和分娩期间会增加抗生素的使用。关于这个问题的数据有限，抗生素在怀孕期间的安全使用和抗生素耐药性仍然是一个关注点。本研究的目的是评估五年来在医院就诊的孕妇使用抗生素的情况。
我们从医院的软件程序中回顾性地收集了患者的抗生素使用和治疗信息，并根据世界卫生组织（WHO）的方法，按照每个住院患者的限定日剂量（DDD）进行表示，时间为 2017 年至 2021 年。我们根据药物名称、类别和食品药品监督管理局（FDA）类别评估抗生素的处方情况。
抗生素的使用在 2017 年至 2019 年期间呈下降趋势，但在 2020 年至 2021 年期间呈上升趋势。头孢曲松是每年使用最多的抗生素，其次是头孢克肟、阿莫西林、甲硝唑、头孢呋辛、氨苄西林和环丙沙星。我们注意到，第一代和第四代头孢菌素未用于这些患者。本研究中只有一小部分女性使用了氨基糖苷类抗生素；氟喹诺酮类药物通常在围产期被禁用。很大一部分处方使用的抗生素被 FDA 归类为 B 类。围产期最常见的感染是肾脏和泌尿道感染，比其他研究中的数量更多。
我们的研究表明，许多用于围产期女性的抗生素类别属于 B 类抗生素，最常开的是头孢菌素。由于缺乏足够的安全性证据，以及对胎儿致畸作用的潜在风险，限制了 C 类和 D 类抗生素的使用。改善产妇健康需要医疗保健专家参与风险评估，并评估现有数据，以选择适当的抗生素、剂量、用药时间和监测。
