Establishing obstetrics-specific metrics and interventions for antimicrobial stewardship

Wong, Jonathan L.; Wooding, Denise J.; Leung, Ssk; Paquette, Vanessa; Elwood, Chelsea

doi:10.1016/j.ajog.2020.08.169

Cited by 1 publication

(2 citation statements)

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“…Wong et al 22 found that non-protocolized interventions were Unsurprisingly, these combinations of antimicrobials were the most prescribed in our study, and 83% of our participants received appropriate empiric antibiotics. Ongoing monitoring for treatment failures allows for internal quality control of such protocols.…”

Section: Discussionmentioning

confidence: 49%

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Empiric antibiotics for peripartum bacteremia: A chart review from a quaternary Canadian centre

Mohn,

Reimer,

Mar

et al. 2023

Intl J Gynecology & Obste

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ObjectiveTo evaluate the effectiveness of empiric antibiotic protocols for peripartum bacteremia at a quaternary institution by describing incidence, microbial epidemiology, clinical source of infection, susceptibility patterns, and maternal and neonatal outcomes.MethodsRetrospective chart review of peripartum patients with positive blood cultures between 2010 and 2018.ResultsThe incidence of peripartum bacteremia was 0.3%. The most cultured organisms were Escherichia coli (51, 26.7%), Streptococcus spp. (52, 27.2%), and anaerobic spp. (35, 18.3%). Of the E. coli cases, 54.9% (28), 19.6% (10), and 19.6% (10) were resistant to ampicillin, first‐ and third‐generation cephalosporins, respectively. Clinical sources of infection included intra‐amniotic infection/endometritis (115, 67.6%), upper and/or lower urinary tract infection (23, 13.5%), and soft tissue infection (8, 4.7%). Appropriate empiric antibiotics were prescribed in 137 (83.0%) cases. There were 7 ICU admissions (4.2%), 18 pregnancy losses (9.9%), 9 neonatal deaths (5.5%), and 6 cases of neonatal bacteremia (3.7%).ConclusionPeripartum bacteremia remains uncommon but associated with maternal morbidity and neonatal morbidity and mortality. Current empiric antimicrobial protocols at our site remain appropriate, but continuous monitoring of antimicrobial resistance patterns is critical given the presence of pathogens resistant to first‐line antibiotics.

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Section: Discussionmentioning

confidence: 49%

“…Wong et al 22 found that non‐protocolized interventions were 3.07 times more likely to be inappropriate compared with protocolized indications in obstetric patients. Hence, ongoing development of antimicrobial protocols is needed, including routine re‐evaluation of local microbial epidemiology and resistance patterns.…”

Section: Discussionmentioning

confidence: 99%