Trends in anti-infective drugs use in pregnancy

Development of knowledge in understanding the use of anti-infective drugs during pregnancy has been limited by difficulties in testing medications in pregnant women and lack of evidence-based data. Overuse of broad spectra agents is associated with development and spread of bacterial resistance, a problem that is faced as a significant threat to the public health.

To describe trends in use of general and broad spectrum anti-infective drugs during pregnancy.

We used the Quebec Pregnancy Registry to analyse trends for use of oral anti-infectives dispensed during pregnancy for the five-year period comprised between January 1998 and December 2002. Trends in use were assessed for classes of anti-infectives and for broad-spectrum drugs. Descriptive statistics were used to summarize the characteristics of the study population. Annual trends for the use of anti-infective drugs were analyzed using the Cochran-Armitage test.

The use of anti-infective drugs and broad spectrum agents during pregnancy decreased from 1998 to 2002 (p ≤ 0.05 for trends). The classes that showed increasing trend for use were: macrolides, quinolones, tetracyclines, urinary anti-infective drugs and antimycotics. Use of penicillins and sulfonamides decreased. Azithromycin showed a remarkable increase in its use: 0.04% of all anti-infective prescriptions in 1998, compared to 10.16% in 2002.

Decrease in the use of broad-spectrum drugs may have been caused by a positive impact of data issued from evidence in everyday life clinical practice. More data is needed to evaluate the impact of the knowledge transfer from evidence-based studies on prescription's trends during pregnancy.