The practice of prescribing antimicrobials to pregnant women with concomitant somatic diseases
Background: Clinical and pharmacoepidemiological studies have been conducted to optimize the use of antibacterial drugs in pregnant women with somatic diseases.Korobkov N.A., Bakulina N.V., Repina M.A., Arnt O.S.
Objective: To analyze the prescription of systemic antimicrobial drugs to pregnant women with concomitant somatic diseases in routine medical practice.
Materials and methods: A non-interventional retrospective analysis of data from different forms of primary medical documentation was carried out in 144 pregnant women who received systemic antimicrobial therapy for somatic diseases.
Results: The investigation revealed the irrational use of antimicrobial drugs in pregnant women with concomitant somatic diseases: the prescription of identical antibiotics for somatic diseases and peripartum infections; the unreasonable use of preventive cycles of antibacterial drugs, the excessive use of restricted antibiotics according to the WHO AWaRe classification database (third-generation cephalosporins) and inhibitor-protected β-lactam agents.
Conclusion: To date, the prescription of systemic antimicrobial drugs to pregnant women with concomitant somatic diseases is rational only in 68.2% of cases.
Authors' contributions: Korobkov N.A. – material collection and processing, analysis of the findings, gatekeeping, writing the text, reviewing the literature; Bakulina N.V., Repina M.A. – concept and design of the investigation, editing the article; Arnt O.S. – statistical data processing. All the authors have made a substantial contribution to the investigation and the article, read, and approved the final version before publication.
Conflicts of interest: The authors declare that there are no conflicts of interest.
Funding: There is no source of funding.
Patient Consent for Publication: All patients provided informed consent for the publication of their data.
Authors' Data Sharing Statement: The data supporting the findings of this study are available on request from the corresponding author after approval from the principal investigator.
For citation: Korobkov N.A., Bakulina N.V., Repina M.A., Arnt O.S. The practice of prescribing antimicrobials to pregnant women with concomitant somatic diseases.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2023; (2): 118-124 (in Russian)
https://dx.doi.org/10.18565/aig.2022.308
Keywords
somatic diseases
pregnancy
antimicrobial therapy
multidrug-resistant microflora
urinary tract infection
bronchopulmonary diseases
References
- Aryee A., Price N. Antimicrobial stewardship – can we afford to do without it? Br. J. Clin. Pharmacol. 2015; 79(2): 173-81. https://dx.doi.org/10.1111/bcp.12417.
- WHO. WHO recommendations for prevention and treatment of maternal peripartum infections. Geneva: WHO; 2015.
- Министерство здравоохранения Российской Федерации. Клинические рекомендации. Инфекция мочевыводящих путей при беременности. М.; 2022. [Ministry of Health of the Russian Federation. Clinical guidelines. Urinary tract infection in pregnancy. Мoscow; 2022. (in Russian)].
- Huttner A., Verhaegh E.M., Harbarth S., Muller A.E., Theuretzbacher U., Mouton J.W. Nitrofurantoin revisited: a systematic review and meta-analysis of controlled trials. J. Antimicrob. Chemother. 2015; 70(9): 2456-64. 1https://dx.doi.org/0.1093/jac/dkv147.
- Палагин И.С., Сухорукова М.В., Дехнич А.В., Эйдельштейн М.В., Перепанова Т.С., Козлов Р.С. и др. Антибиотикорезистентность возбудителей внебольничных инфекций мочевых путей в России: результаты многоцентрового исследования «ДАРМИС-2018». Клиническая микробиология и антимикробная химиотерапия. 2019; 21(2): 134-4. [Palagin I.S., Sukhorukova M.V., Dekhnich A.V., Edelstein M.V., Perepanova T.S., Kozlov R.S. et al. Antimicrobial resistance of pathogens causing community – acquired urinary tract infections in Russia: results of the multicenter study "DARMIS – 2018". Clinical Microbiology and Antimicrobial Chemotherapy. 2019; 21(2): 134-46. (in Russian)].
- Министерство здравоохранения Российской Федерации. Приказ от 1 ноября 2012 г. N 572н «Об утверждении порядка оказания медицинской помощи по профилю "акушерство и гинекология (за исключением использования вспомогательных репродуктивных технологий)"» (зарегистрировано в Минюсте России 2 апреля 2013 г. № 27960). [Ministry of Health of the Russian Federation. Order N 572n dated November 1, 2012 "On approval of the procedure for providing medical care in the field of obstetrics and gynecology (except the use of assisted reproductive technologies)"(registered with the Ministry of Justice of Russia on April 2, 2013 N 27960).(in Russian)].
- Министерство здравоохранения Российской Федерации. Приказ от 20.10.2020 N 1130н "Об утверждении Порядка оказания медицинской помощи по профилю "акушерство и гинекология" (зарегистрировано в Минюсте России 12.11.2020 № 60869). [Ministry of Health of the Russian Federation. Order N 572n dated November 1, 2012 "On approval of the procedure for providing medical care in the field of obstetrics and gynecology (except the use of assisted reproductive technologies)" (registered with the Ministry of Justice of Russia on April 2, 2013 N 27960). (in Russian)].
- Министерство здравоохранения Российской Федерации. Клинические рекомендации. Острые респираторные вирусные инфекции у взрослых. M.; 2021. [Ministry of Health of the Russian Federation. Clinical guidelines. Acute respiratory viral infections in adults. Moscow; 2021. (in Russian)].
- Министерство здравоохранения Российской Федерации. Клинические рекомендации. Бронхит. М.; 2021. [Ministry of Health of the Russian Federation. Clinical guidelines. Bronchitis. Moscow; 2021. (in Russian)].
- Министерство здравоохранения Российской Федерации. Клинические рекомендации. Внебольничная пневмония у взрослых. М.; 2022. [Ministry of Health of the Russian Federation. Clinical guidelines. Community-acquired pneumonia in adults. Moscow; 2022. (in Russian)].
- Macones G.A., Cleary K.L., Parry S., Stamilio D.M., Cahill A.G., Odibo A.O., Rampersad R. The timing of antibiotics at cesarean: A randomized controlled trial. Am. J. Perinatol. 2012; 29(4): 273-6. https://dx.doi.org/10.1055/s-0031-1295657.
- WHO model list of essential medicines. 20th list (March 2017) Geneva: World Health Organization; 2017. Available at: www.who.int/publications/i/item/2021-aware-classification (Accessed 03.01.2023).
- Mehta N., Chen K., Hardy E., Powrie R. Respiratory disease in pregnancy. Best. Pract. Res. Clin. Obstet. Gynaecol. 2015; 29(5): 598-611. https://dx.doi.org/10.1016/j.bpobgyn.2015.04.005.
- Stinson L.F., Payne M.S., Keelan J.A. Planting the seed: origins, composition, and postnatal health significance of the fetal gastrointestinal microbiota. Crit. Rev. Microbiol. 2017; 43(3): 352-69. https://dx.doi.org/10.1080/1040841X.2016.1211088.
Received 21.12.2022
Accepted 08.02.2023
About the Authors
Nikolay A. Korobkov, PhD, Associate Professor at the S.N. Davydov Department of Obstetrics and Gynecology, I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russia, nikolai_korobkov@mail.ru, https://orcid.org/0000-00017279-2535; eLibrary SPIN: 4191-3581,41 Kirochnaya str., St. Petersburg 191015, Russia.
Natalia V. Bakulina, Dr. Med. Sci., Professor, Head of the Department of Internal Medicine, Clinical Pharmacology and Nephrology, Vice-Rector for Science and Innovation, I.I. Mechnikov North-West State Medical University, Ministry of Health of Russia, https://orcid.org/0000-0003-4075-4096, eLibrary SPIN: 9503-8950,
41 Kirochnaya str., St. Petersburg, 191015, Russia.
Margarita A. Repina, Dr. Med. Sci., Professor, I.I. Mechnikov North-West State Medical University, Ministry of Health of Russia, AuthorID: 496280,
41 Kirochnaya str., St. Petersburg, 191015, Russia.
Olga S. Arnt, PhD, Associate Professor at the S.N. Davydov Department of Obstetrics and Gynecology, I.I. Mechnikov Northwestern State Medical University,
Ministry of Health of Russia, https://orcid.org/0000-0003-1565-2012, eLibrary SPIN: 1482-0917, 41 Kirochnaya str., St. Petersburg, 191015, Russia.
Corresponding author: Nikolay A. Korobkov, nikolai_korobkov@mail.ru
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