Bailey Pamela, Pazienza Grace, Foy-Crowder Alexia, Schacht Lance, Thomas Mattie Jo, Kohn Joseph, Withers Sarah, Britt Jessica, Stuart Sean, Crockett Amy
University of South Carolina School of Medicine, Columbia, SC, USA.
Department of Internal Medicine, Division of Infectious Diseases, Prisma Health Midlands, Columbia, SC, USA.
Antimicrob Steward Healthc Epidemiol. 2025 Sep 5;5(1):e204. doi: 10.1017/ash.2025.10121. eCollection 2025.
Antimicrobial resistance is an urgent public health threat, and despite significant consumption of antimicrobials in pregnancy, there remain opportunities for improvement of their use in the obstetric population. Improvement in antimicrobial utilization can be streamlined by assessing baseline characteristics, utilization of diagnostic testing, awareness of peripartum protocols, and recognition of penicillin allergies. In a single healthcare system including 8 obstetric hospitals, an administrative review identified 199 different regimens used among 8,528 patients based on American College of Obstetrician and Gynecologists (ACOG) guidelines. Other notable factors include 65.6% of patients having no cultures obtained despite being started on empiric antibiotics, duplicative coverage when multiple clinical scenarios overlap, and a high incidence of reported penicillin allergies with obstetric providers lacking comfort to reconcile and de-label allergies. By reviewing these individual aspects, this can highlight opportunities for improvement of antimicrobial use and stewardship in obstetric populations.
抗菌药物耐药性是一个紧迫的公共卫生威胁，尽管孕期抗菌药物的使用量很大，但在产科人群中改善其使用仍有机会。通过评估基线特征、诊断检测的使用情况、围产期方案的知晓程度以及对青霉素过敏的识别，可以简化抗菌药物使用的改善。在一个包括8家产科医院的单一医疗系统中，一项行政审查根据美国妇产科医师学会（ACOG）指南，在8528名患者中确定了199种不同的治疗方案。其他值得注意的因素包括，尽管开始使用经验性抗生素，但65.6%的患者未进行培养，多种临床情况重叠时存在重复覆盖，以及报告的青霉素过敏发生率较高，产科医护人员对协调和去除过敏标签缺乏信心。通过审查这些个体方面，可以突出改善产科人群抗菌药物使用和管理的机会。
