The use and safety of antibiotic therapy in pregnant women.

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.