Prescription of systemic antibiotics during pregnancy in primary care in Friuli Venezia Giulia, Northeastern Italy

Valent, Francesca; Gongolo, Francesco; Deroma, Laura; Zanier, Loris

doi:10.3109/14767058.2014.906572

Cited by 11 publications

(19 citation statements)

References 16 publications

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“…The estimated rate of drug prescriptions in pregnancy among women delivering in Latium from 2008 to 2012 was 81% excluding vitamin and minerals. To our knowledge the only two other population-based studies conducted in 2004 and in 2011 in two regions of northern Italy [ 13 , 15 ] reported respectively 48,3 and 72,7% of antenatal prescriptions.…”

Section: Discussionmentioning

confidence: 93%

“…This proportion is higher compared to other population-based studies in European settings ranging from 27 to 32% [ 20 – 22 ] and similar to a French study where 42% of pregnant women were exposed to antimicrobials [ 23 ]. The previous Italian studies reported respectively 37.2 and 24.8% of women prescribed with antibiotics during pregnancy [ 13 , 15 ]. Given the growing problem of bacterial resistance, an increase in the use of antibiotics during pregnancy requires careful thought in terms of prescriptive appropriateness [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…Studies providing additional information and updates on the use and appropriateness of medical drug consumption during pregnancy are of pivotal importance for women who are or are planning to become pregnant, for health care providers and for the society. So far, a limited number of studies has examined the use of prescription drugs among pregnant women in Italy [ 12 – 15 ]. The objective of this population-based study is the analysis of drug prescribing among pregnant women in Latium with specific regard to inappropriate and potentially or known teratogenic drugs.…”

Section: Introductionmentioning

confidence: 99%

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Drug prescribing during pregnancy in a central region of Italy, 2008-2012

Ventura¹,

Maraschini

D'Aloja

et al. 2018

BMC Public Health

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BackgroundDrug consumption during pregnancy is a matter of concern, especially regarding drugs known or suspected to be teratogens. Little is known about drug use in pregnant women in Italy. The present study is aimed at examining the prevalence, and to detect potential inappropriateness of drug prescribing among pregnant women in Latium, a region of central Italy.MethodsThis retrospective study was conducted on a cohort of women aged 18-45 years who delivered between 2008 and 2012 in public hospitals. Women were enrolled through the Regional Birth Register. After linking the regional Health Information Systems and the Regional Drug Claims Register, women’s clinical data and prescribed medications were analyzed. Italian Medicine Agency (AIFA) and US Food and Drug Administration (FDA) evidence were used to investigate inappropriate prescribing and teratogenic risk.ResultsExcluding vitamins and minerals, 80.6% (n = 153,079) of the women were prescribed at least one drug during pregnancy, with an average of 4.6 medications per pregnancy. Drugs for blood and hematopoietic organs were the most commonly prescribed (53.0%,), followed by anti-infectives for systemic use (50.7%). Among the inappropriate prescriptions, progestogen supplementation was given in 20.1% of pregnancies; teratogen drugs were prescribed in 0.8%, mostly angiotensin co-enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) (0.3%).ConclusionsIn Latium, drugs are widely used in pregnancy. Prescriptions of inappropriate drugs are observed in more than a fifth of pregnancies, and teratogens are still used, despite their known risk. Continuous updates of information provided to practitioners and an increased availability of information to women might reduce inappropriate prescribing.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Drug prescribing during pregnancy in a central region of Italy, 2008-2012

Ventura¹,

Maraschini

D'Aloja

et al. 2018

BMC Public Health

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“…Clearly, as before ( 44 ), and recognizing the issues of antimicrobial resistance, one avenue would exploit antibiotics much more commonly than now. We note that pharmaceutical drugs are prescribed or taken during 50% or more of pregnancies ( 819 – 828 ). Anti-infectives are the most common such drugs, and some 20–25% of women or more are prescribed one or more antibiotics during their pregnancies ( 820 , 821 , 824 , 826 , 828 – 832 ).…”

Section: Treatment Options Based On (Or Consistent With) the Ideas Prmentioning

confidence: 99%

Immunological Tolerance, Pregnancy, and Preeclampsia: The Roles of Semen Microbes and the Father†

Kenny

Kell

2018

Front. Med.

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Although it is widely considered, in many cases, to involve two separable stages (poor placentation followed by oxidative stress/inflammation), the precise originating causes of preeclampsia (PE) remain elusive. We have previously brought together some of the considerable evidence that a (dormant) microbial component is commonly a significant part of its etiology. However, apart from recognizing, consistent with this view, that the many inflammatory markers of PE are also increased in infection, we had little to say about immunity, whether innate or adaptive. In addition, we focused on the gut, oral and female urinary tract microbiomes as the main sources of the infection. We here marshall further evidence for an infectious component in PE, focusing on the immunological tolerance characteristic of pregnancy, and the well-established fact that increased exposure to the father’s semen assists this immunological tolerance. As well as these benefits, however, semen is not sterile, microbial tolerance mechanisms may exist, and we also review the evidence that semen may be responsible for inoculating the developing conceptus (and maybe the placenta) with microbes, not all of which are benign. It is suggested that when they are not, this may be a significant cause of PE. A variety of epidemiological and other evidence is entirely consistent with this, not least correlations between semen infection, infertility and PE. Our view also leads to a series of other, testable predictions. Overall, we argue for a significant paternal role in the development of PE through microbial infection of the mother via insemination.

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“…Clearly, as before [32], and recognising the issues of antimicrobial resistance, one avenue would exploit antibiotics much more commonly than now. We note that pharmaceutical drugs are prescribed or taken during 50% or more of pregnancies [769][770][771][772][773][774][775][776][777][778]. Anti-infectives are the most common such drugs, and some 20-25% of women or more are prescribed one or more antibiotics during their pregnancies [770; 771; 774; 776; 777; 779-782].…”

Section: Treatment Options Based On (Or Consistent With) the Ideas Prmentioning

confidence: 99%

Immunological tolerance, pregnancy and pre-eclampsia: the roles of semen microbes and the father¹

Kenny

Kell

2017

Preprint

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Although it is widely recognised as involving two stages (poor placentation followed by oxidative stress/inflammation), the precise originating causes of pre-eclampsia (PE) remain elusive. We have previously brought together some of the considerable evidence that a (dormant) microbial component is commonly a significant part of its aetiology. However, apart from recognising, consistent with this view, that the many inflammatory markers of PE are also increased in infection, we had little to say about immunity, whether innate or adaptive. In addition, we focussed on the gut, oral and female urinary tract microbiomes as the main sources of the infection. We here marshall further evidence for an infectious component in PE, focussing on the immunological tolerance characteristic of pregnancy, and the well-established fact that increased exposure to the father’s semen assists this immunological tolerance. As well as these benefits, however, semen is not sterile, microbial tolerance mechanisms may exist, and we also review the evidence that semen may be responsible for inoculating the developing conceptus with microbes, not all of which are benign. It is suggested that when they are not, this may be a significant cause of preeclampsia. A variety of epidemiological and other evidence is entirely consistent with this, not least correlations between semen infection, infertility and PE. Our view also leads to a series of other, testable predictions. Overall, we argue for a significant paternal role in the development of PE through microbial infection of the mother via insemination. “In one of the last articles which he wrote, the late Professor F J Browne (1958) expressed the opinion that all the essential facts about pregnancy toxaemia are now available and that all that is required to solve the problem is to fit them together in the right order, like the pieces of a jigsaw puzzle” [1]“It appears astonishing how little attention has been given in reproductive medicine to the maternal immune system over the last few decades.” [2]

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Prescription of systemic antibiotics during pregnancy in primary care in Friuli Venezia Giulia, Northeastern Italy

Abstract: In order to improve the prescription of antibiotics in pregnancy, an audit with the GPs is warranted to understand their motivations, discuss clinical cases and build consensus guidelines on which antibiotics should be preferred for use in pregnancy.

Cited by 11 publications

References 16 publications

Drug prescribing during pregnancy in a central region of Italy, 2008-2012

Drug prescribing during pregnancy in a central region of Italy, 2008-2012

Immunological Tolerance, Pregnancy, and Preeclampsia: The Roles of Semen Microbes and the Father†

Immunological tolerance, pregnancy and pre-eclampsia: the roles of semen microbes and the father¹

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Prescription of systemic antibiotics during pregnancy in primary care in Friuli Venezia Giulia, Northeastern Italy

Abstract: In order to improve the prescription of antibiotics in pregnancy, an audit with the GPs is warranted to understand their motivations, discuss clinical cases and build consensus guidelines on which antibiotics should be preferred for use in pregnancy.

Cited by 11 publications

References 16 publications

Drug prescribing during pregnancy in a central region of Italy, 2008-2012

Drug prescribing during pregnancy in a central region of Italy, 2008-2012

Immunological Tolerance, Pregnancy, and Preeclampsia: The Roles of Semen Microbes and the Father†

Immunological tolerance, pregnancy and pre-eclampsia: the roles of semen microbes and the father1

Contact Info

Product

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Immunological tolerance, pregnancy and pre-eclampsia: the roles of semen microbes and the father¹