Winteler Cristina, Ardabili Sara, Hodel Markus, Stocker Martin
Faculty of Health Science and Medicine, University of Lucerne, Lucerne, Switzerland.
Department of Gynecology and Obstetrics, Luzerner Kantonsspital LUKS, Lucerne, Switzerland.
J Perinatol. 2025 Jan 20. doi: 10.1038/s41372-025-02209-0.
The perinatal period is associated with high antibiotic exposure, which raises concerns about antimicrobial resistance (AMR) and future health impacts. The aim of this comprehensive systematic review, including publications from 2000 to 2022, is to describe the current evidence and state of antimicrobial stewardship (AMS) in the perinatal period and to identify gaps in knowledge for future research. The review included 36 studies from the Americas, Europe, Asia and Australia, involving a total of 64,798 pregnant women and 84,137 newborns. 33 out of 36 studies reported reduced antibiotic use, suggesting the potential to reduce antibiotic exposure. There is a lack of studies in the antepartum and intrapartum periods, of comprehensive AMS strategies across the entire perinatal period, and from low- and middle-income countries with a high burden of maternal and neonatal morbidity and mortality. Future research should include prospective, adequately powered studies including safety endpoints, clinical outcomes and AMR reports.
围产期与高抗生素暴露相关，这引发了对抗菌素耐药性（AMR）及未来健康影响的担忧。本全面系统综述涵盖2000年至2022年的出版物，旨在描述围产期抗菌药物管理（AMS）的现有证据和现状，并找出未来研究的知识空白。该综述纳入了来自美洲、欧洲、亚洲和澳大利亚的36项研究，共涉及64798名孕妇和84137名新生儿。36项研究中有33项报告称抗生素使用减少，表明有降低抗生素暴露的潜力。目前缺乏关于产前和产时阶段、整个围产期综合AMS策略以及来自孕产妇和新生儿发病率及死亡率负担较高的低收入和中等收入国家的研究。未来的研究应包括前瞻性、有足够样本量的研究，涵盖安全终点、临床结局和AMR报告。
