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Factors associated with potentially harmful antibiotic prescription during pregnancy: a population-based study
Yichen Lee1, Chuchieh Chen2, Dachen Chu2,3,4
1Department of Health Administration, Tzu-Chi University of Science and Technology, Hualien, Taiwan.
Insights
Antibiotic use during pregnancy poses risks to fetuses. This study identified specific patient and physician factors associated with prescribing potentially harmful antibiotics to pregnant women, highlighting areas for improved prescribing practices.
Area of Science:
- Obstetrics and Gynecology
- Pharmacology
- Public Health
Background:
- Inappropriate antibiotic use during pregnancy can negatively impact fetal development.
- Limited research exists on factors influencing the prescription of teratogenic antibiotics in pregnant individuals.
Purpose of the Study:
- To investigate the frequency and associated factors of antibiotic prescriptions potentially harmful to the fetus.
- To identify patient, physician, and healthcare setting characteristics linked to prescribing these medications during pregnancy.
Main Methods:
- Population-based cross-sectional study utilizing the National Health Insurance Research Database.
- Antibiotics classified as potentially harmful to the fetus included sulfonamides, trimethoprim, tetracycline, and quinolones.
- Multivariate logistic regression analysis was employed to determine independent risk factors.
Main Results:
- 33.67% of pregnant subjects received antibiotic prescriptions; 6.31% were potentially harmful.
- Younger pregnant women (<20 years), those in the first trimester, and with urogenital infections faced higher risks.
- Non-gynaecologists, older physicians (39-49, ≥50 years), and those in clinics showed increased prescribing risks.
Conclusions:
- Findings underscore the need for enhanced awareness of antibiotic prescription guidelines for pregnant patients.
- Quality improvement measures should target specific demographic and clinical factors to reduce exposure to harmful antibiotics.
Rationale, Aims And Objectives:
Inappropriate antibiotic prescriptions during pregnancy may adversely affect the fetus. There were few studies on factors associated with antibiotic prescriptions potentially harmful to the fetus.
Methods:
This was a population-based cross-sectional study using data from National Health Insurance Research Database. We calculated the frequency of antibiotic prescription according to the status of pregnancy, type of infections, characteristics of patients, doctors and medical institutions. According to the British National Formulary, sulfonamides, trimethoprim, tetracycline and quinolones were classified as antibiotics potentially harmful to the fetus. A multivariate logistic regression analysis was performed to evaluate the independent effect of various characteristic on antibiotic prescriptions, during pregnancy, potentially harmful to the fetus.
Results:
Among the 19 464 pregnant subjects, 6554 (33.67%) received antibiotic prescriptions during pregnancy. Antibiotic prescriptions potentially harmful to the fetus accounted for 6.31% of all antibiotic prescriptions during pregnancy. Pregnant women aged <20 years, in their first trimester, and who were presenting with urogenital infections had the highest risks of receiving antibiotic prescriptions potentially harmful to the fetus. Non-gynaecologists, doctors aged 39-49 or ≥50 years, and doctors at clinics had higher risks of prescribing antibiotics potentially harmful to the fetus.
Conclusions:
Measures to improve the quality of practices should include efforts to increase awareness of antibiotic prescription guidelines for the treatment of infections in the pregnant population.
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