The use and safety of antibiotic therapy in pregnant women.
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Date
2020
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Abstract
Background
Antibiotic therapy in pregnant women has significantly increased in the effort to reduce maternal and
neonatal deaths. However, antibiotic exposure may negatively affect the developing foetus.
Information on the use, safety, and impact of antibiotics on birth outcomes and maternal-foetal health
in low and middle-income countries are limited. This study aims to evaluate the use of antibiotics
among pregnant women by quantifying antibiotic use and commenting on their safety profile.
Furthermore, the risk perception of antibiotics among pregnant women, across all geographic regions,
were determined.
Method
Patient demographics and treatment information were obtained from MediTech®; an electronic
patient information database, from January 2019 to July 2019. Descriptive and analytical measures
were used to describe both patient demographics and antibiotic treatment variables. A systematic
review was conducted to determine the risk perception of antibiotics among pregnant women. A
systematic search for studies from January 2000 to December 2019 were performed using four
databases, which included: PubMed, Scopus, CINAHL, and Psycinfo. The systematic review involved
the categorisation of data into relevant themes and sub-themes; data transformation and outcomes
were discussed using narrative and thematic synthesis.
Results
A total of 416 antibiotic prescriptions, issued to 184 patients, were reviewed. Penicillins (39.7%),
macrolides (13.0%), and combination penicillin-and-beta-lactam inhibitors (12.3%) were reported as
the most commonly prescribed antibiotics in pregnancy. Most antibiotics were prescribed for diseases
of the circulatory system (36.1%). A significant correlation was found between the duration of therapy
and the age of the patient (>20, p=0.0009, 20-29, p=0.017, 30-42, p=0.03). The systematic review
identified a total of 1539 articles, of which 14 studies met the inclusion criteria. The selected studies
included four regions: Europe, America, Asia, and Africa. Limited studies were found in low and
middle-income countries, especially among rural communities.
Conclusion
Penicillins remain as the most common antibiotic used in pregnant women. However, the use of other
antibiotic classes apart from the commonly used beta-lactams are also increasing, showing evidence
of antibiotic resistance. In addition, the influence of perception significantly affects antibiotic use
among pregnant women.
Description
Masters Degree. University of KwaZulu-Natal, Durban.