ABSTRACT
BACKGROUND: Antimicrobial agents are among the most commonly prescribed drugs in pregnancy due to the increased susceptibility to infections during pregnancy. Antimicrobials can contribute to different maternal complications. Therefore, it is important to study their patterns in prescription and utilization. The data regarding this issue is scarce in Saudi Arabia. Therefore, the aim of this study is to generate data on the antimicrobial agents that are most commonly prescribed during pregnancy as well as their indications and safety. METHODS: This is a retrospective study focusing on pregnant women with a known antimicrobial use at Johns Hopkins Aramco Healthcare (JHAH). The sample included 344 pregnant women with a total of 688 antimicrobial agents prescribed. Data was collected on the proportion of pregnant women who received antimicrobial agents and on the drug safety during pregnancy using the risk categorization system of the U.S. Food and Drug Administration (FDA). RESULTS: The results showed that urinary tract infections (UTIs) were the most reported (59%) infectious diseases. Around 48% of pregnant women received antimicrobial medications at some point during pregnancy. The top two antimicrobial agents based on prescription frequency were B-lactams (44.6%) and azole anti-fungals (30%). The prescribed drugs in the study were found to be from classes B, C and D under the FDA risk classification system. CONCLUSION: The study revealed a high proportion of antimicrobials prescribed during pregnancy that might pose risks to mothers and their fetuses. Future multicenter studies are warranted to evaluate the rational prescription of antimicrobial medications during pregnancy.
ABSTRACT
BACKGROUND: The emergence of antimicrobial resistance of many bacteria is a significant drawback of antimicrobial use. A key measure to assess antimicrobial use is point prevalence study. METHODS: This was a point prevalence study of all hospitalized patients at Johns Hopkins Aramco Healthcare, a 350-bed hospital, and was conducted at two-points from January 2017 to January 2019. We recorded systemic antibiotic use and the indications as prophylactic, empiric, and definite therapy. RESULT: Of the 489 hospitalized patients whom were included, 200 (40%) were on systemic antibiotics. Of the total antibiotic indications, 144 (72%) were empiric, 17 (8.5) were prophylactic antibiotics, and 39 (19.5%) were definite therapy, according to hospital guidelines. Most commonly used antibiotics were meropenem (18%), cefazolin (10%), and ceftriaxone (8%). Of included patients, 29.4% were on a single antibiotic, 10% recieved two antibiotics, and 1.4% were on three antibiotics. Of the patients receiving an antibiotic that could be given orally, only 41.4% received oral therapy. CONCLUSION: A large percentage of patients were on empiric antimicrobial therapy and areas for further improvements in antimicrobial stewardship includes intravenous to oral switch, evaluating the need for combination therapy, restrictions, education and putting appropriate use guidelines.
