Real-world antibiotic utilization during pregnancy in Italy: a multiregional retrospective population-based study

Area of Science:

• Pharmacovigilance
• Reproductive Health
• Public Health

Background:

• Antibiotic use during pregnancy is frequent, yet clinical trial evidence is limited.
• Drug utilization studies are crucial for understanding medication use in pregnancy.
• This study examines antibiotic exposure in pregnant women across Italy.

Purpose of the Study:

• To describe antibiotic exposure patterns during pregnancy in Italy.
• To analyze antibiotic utilization at national and regional levels.
• To identify variations in antibiotic use across different trimesters and regions.

Main Methods:

• Retrospective population-based study of women giving birth between 2016-2018 in selected Italian regions.
• Data collected from regional healthcare databases, including sociodemographic and clinical characteristics.
• Antibiotic use prevalence estimated across pre-pregnancy, pregnancy, and post-pregnancy trimesters, stratified by region and invasive prenatal diagnostics.

Main Results:

• Over 449,000 women were included; 33.9% used antibiotics pre-pregnancy, 31.8% during, and 29.3% post-pregnancy.
• Significant regional disparities observed, with Apulia showing highest usage and Lombardy/Veneto the lowest.
• Antibiotic use peaked during the second trimester of pregnancy (16.0%) and was higher following invasive prenatal diagnostic procedures.

Conclusions:

• Antibiotic use in Italian pregnancies generally aligns with European guidelines.
• Observed regional variations and potential misuse of specific antibiotics warrant attention.
• Continuous monitoring of outcomes is recommended to reduce excessive antibiotic utilization and promote appropriate practices.