The Prevalence and Factors Associated with Prophylactic Antibiotic Use during Delivery: A Hospital-Based Retrospective Study in Palembang, Indonesia

Karmila, Ariesti; Zulkarnain, Muhammad; Martadiansyah, Abarham; Mirani, Putri; Bernolian, Nuswil; Gardiner, Joseph C.; Zhang, Lixin

doi:10.3390/antibiotics10081004

Cited by 6 publications

(10 citation statements)

References 52 publications

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“…Compared with studies from LMICs, the prevalence in this study was similar to a study in Indonesia (47%) [21] and much lower than a study in India (87% for vaginal delivery and 92% for cesarean delivery) [6]. The prevalence of clinician adherence in this study was almost 80%, which was higher than in Indonesia (69%) [21]. The WHO guideline strongly recommends prophylactic antibiotics for cesarean deliveries unless the patient is already receiving an antibiotic regimen with equivalent broad spectrum coverage for existing infectious [1,12].…”

Section: Comparison With Previous Literaturesupporting

confidence: 85%

“…Existing research shows that prophylactic antibiotic use during delivery was 30%, 33%, and 39% respectively in the USA [18], Denmark [19], and Canada [20]. Compared with studies from LMICs, the prevalence in this study was similar to a study in Indonesia (47%) [21] and much lower than a study in India (87% for vaginal delivery and 92% for cesarean delivery) [6]. The prevalence of clinician adherence in this study was almost 80%, which was higher than in Indonesia (69%) [21].…”

Section: Comparison With Previous Literaturesupporting

confidence: 68%

“…Improving the clinician's adherence to the antibiotic prescribing guidelines could reduce inappropriate prophylaxis antibiotic use during delivery because the guidelines were developed to limit the emergence of antibiotic resistance without compromising mother and infant health outcomes [21]. Interventions need to be multifaceted and permanent to guarantee lasting change [26,28].…”

Section: Discussionmentioning

confidence: 99%

“…The obstetric conditions for antibiotic prophylaxis, including PROM, meconium-stained amniotic fluid, and severe perineal trauma, were associated with higher antibiotic prophylaxis use and lower adherence. The main possible reason for the contradictory results is that these obstetric conditions often accompany other symptoms that need to be treated with antibiotics for therapeutic purposes [21].…”

Section: Comparison With Previous Literaturementioning

confidence: 99%

“…However, we repeated our analysis in a healthier subpopulation without any measured indicator of the therapeutic use of antibiotics, which minimized the drawback. Second, the retrospective nature of the study design hampered the ability to explore the associated clinician's characteristics regarding adherence [21]. Besides, we cannot evaluate the temporal trends of prophylactic antibiotic use and clinician adherence in obstetrics practice in China based on the CLDS data.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

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Prophylactic antibiotic use during labor and delivery in China: a nationwide, multicenter, hospital-based, cross-sectional study

Tang

Huo

et al. 2022

BMC Med

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Background Prophylactic antibiotic use during delivery is common in routine obstetric practice to prevent infection globally, especially in low- and middle-income countries. In China, however, little is currently known about the national estimates for prophylactic antibiotic use during delivery. Therefore, we aimed to describe the prevalence of prophylactic antibiotic use and guideline adherence using national data in China. Methods This cross-sectional study analyzed a national dataset from the China Labor and Delivery Survey in 2015–2016. The primary outcomes were prophylactic antibiotic use and clinician adherence to WHO recommendations for the prevention and treatment of maternal peripartum infections. We estimated the weighted prevalence of the outcomes with Taylor series linearization and investigated the associated factors of the outcomes with logistic regression. Results Of the 72,519 deliveries, the prevalence of antibiotic prophylaxis was 52.0%, varying from 92.8% in Shanxi to 17.3% in Hainan. The prevalence of clinician adherence to the WHO guideline was 79.9%, ranging from 93.4% in Shandong to 50.0% in Shanxi. Prophylactic antibiotic use was associated with cesarean delivery (AOR, 55.77; 95%CI, 25.74–120.86), operative vaginal delivery (AOR, 4.00; 95%CI, 1.64–9.78), preterm (AOR, 1.96; 95%CI, 1.60–2.41), premature rupture of membranes (PROM) (AOR, 2.80; 95%CI, 1.87–4.18), and meconium-stained amniotic fluid (AOR, 1.91; 95%CI, 1.30–2.81) in all deliveries and also episiotomy (AOR, 1.48; 95%CI, 1.02–2.16) in vaginal deliveries. Clinician adherence was positively associated with cesarean delivery (AOR, 5.72; 95%CI, 2.74–11.93) while negatively associated with operative vaginal delivery (AOR, 0.26; 95%CI, 0.11–0.61), PROM (AOR, 0.50; 95%CI, 0.35–0.70), and meconium-stained amniotic fluid (AOR, 0.66; 95%CI, 0.48–0.91) in all deliveries. In vaginal deliveries, clinician adherence was negatively associated with episiotomy (AOR, 0.67; 95%CI, 0.46–0.96) and severe perineal trauma (AOR, 0.09; 95%CI, 0.02–0.44). Besides, clinicians in general hospitals prescribed prophylactic antibiotics more likely (AOR, 2.79; 95%CI, 1.50–5.19) and had a lower adherence (AOR, 0.38; 95%CI, 0.20–0.71) than their peers in maternity hospitals. Conclusions We observed that about half of all deliveries in China received antibiotics for prophylaxis, and most deliveries were prescribed according to the WHO guideline. Furthermore, the two prevalence rates for prophylactic antibiotic use and clinician adherence varied widely across provinces of China.

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Section: Comparison With Previous Literaturesupporting

confidence: 85%

Section: Comparison With Previous Literaturesupporting

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Section: Comparison With Previous Literaturementioning

confidence: 99%

Section: Strengths and Limitationsmentioning

confidence: 99%

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Prophylactic antibiotic use during labor and delivery in China: a nationwide, multicenter, hospital-based, cross-sectional study

Tang

Huo

et al. 2022

BMC Med

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Transfer of antibiotics and their metabolites in human milk: Implications for infant health and microbiota

et al. 2022

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Antibiotics are an essential tool for perinatal care. While antibiotics can play a life‐saving role for both parents and infants, they also cause collateral damage to the beneficial bacteria that make up the host gut microbiota. This is especially true for infants, whose developing gut microbiota is uniquely sensitive to antibiotic perturbation. Emerging evidence suggests that disruption of these bacterial populations during this crucial developmental window can have long‐term effects on infant health and development. Although most current studies have focused on microbial disruptions caused by direct antibiotic administration to infants or prenatal exposure to antibiotics administered to the mother, little is known about whether antibiotics in human milk may pose similar risks to the infant. This review surveys current data on antibiotic transfer during lactation and highlights new methodologies to assess drug transfer in human milk. Finally, we provide recommendations for future work to ensure antibiotic use in lactating parents is safe and effective for both parents and infants.

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Point prevalence of evidence-based antimicrobial use among hospitalized patients in sub-Saharan Africa: a systematic review and meta-analysis

Boltena,

Wolde,

Hailu

et al. 2024

Sci Rep

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Excessive and improper use of antibiotics causes antimicrobial resistance which is a major threat to global health security. Hospitals in sub-Saharan Africa (SSA) has the highest prevalence of antibiotic use. This systematic review and meta-analysis aimed to determine the pooled point prevalence (PPP) of evidence-based antimicrobial use among hospitalized patients in SSA. Literature was retrieved from CINAHL, EMBASE, Google Scholar, PubMed, Scopus, and Web of Science databases. Meta-analysis was conducted using STATA version 17. Forest plots using the random-effect model were used to present the findings. The heterogeneity and publication bias were assessed using the I2 statistics and Egger’s test. The protocol was registered in PROSPERO with code CRD42023404075. The review was conducted according to PRISMA guidelines. A total of 26, 272 study participants reported by twenty-eight studies published from 10 countries in SSA were included. The pooled point prevalence of antimicrobial use in SSA were 64%. The pooled estimate of hospital wards with the highest antibiotic use were intensive care unit (89%). The pooled prevalence of the most common clinical indication for antibiotic use were community acquired infection (41%). The pooled point prevalence of antimicrobial use among hospitalized patients were higher in SSA. Higher use of antibiotics was recorded in intensive care units. Community acquired infection were most common clinical case among hospitalized patients. Health systems in SSA must design innovative digital health interventions to optimize clinicians adhere to evidence-based prescribing guidelines and improve antimicrobial stewardship.

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The Prevalence and Factors Associated with Prophylactic Antibiotic Use during Delivery: A Hospital-Based Retrospective Study in Palembang, Indonesia

Cited by 6 publications

References 52 publications

Prophylactic antibiotic use during labor and delivery in China: a nationwide, multicenter, hospital-based, cross-sectional study

Prophylactic antibiotic use during labor and delivery in China: a nationwide, multicenter, hospital-based, cross-sectional study

Transfer of antibiotics and their metabolites in human milk: Implications for infant health and microbiota

Point prevalence of evidence-based antimicrobial use among hospitalized patients in sub-Saharan Africa: a systematic review and meta-analysis

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