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Antibiotics in Pregnancy

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1. Antibiotics for treating gonorrhoea in pregnancy. (PubMed)

Antibiotics for treating gonorrhoea in pregnancy. Gonorrhoea is a sexually transmitted infection that is caused by Neisseria gonorrhoeae, and is a major public health challenge today. N gonorrhoeae can be transmitted from the mother's genital tract to the newborn during birth, and can cause gonococcal ophthalmia neonatorum as well as systemic neonatal infections. It can also cause endometritis and pelvic sepsis in the mother. This review updates and replaces an earlier Cochrane Review (...) on antibiotics for treating this infectious condition.To assess the clinical effectiveness and harms of antibiotics for treating gonorrhoea in pregnant women.We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 May 2017), LILACS database (1982 to April 5, 2017), the WHO International Clinical Trials Registry Platform (ICTRP; April 5, 2017), ClinicalTrials.gov (April 5, 2017), the ISRCTN Registry (April 5, 2017), and Epistemonikos (April 5, 2017). We also searched reference lists

2018 Cochrane

2. Associations between use of macrolide antibiotics during pregnancy and adverse child outcomes: A systematic review and meta-analysis. (PubMed)

Associations between use of macrolide antibiotics during pregnancy and adverse child outcomes: A systematic review and meta-analysis. Evidence on adverse effects of maternal macrolide use during pregnancy is inconsistent. We conducted a systematic review and meta-analysis to investigate the association between macrolide use during pregnancy and adverse fetal and child outcomes.We included observational studies and randomised controlled trials (RCTs) that recorded macrolide use during pregnancy (...) during pregnancy was associated with an increased risk of miscarriage (pooled ORobs 1·82, 95% CI 1·57-2·11, three studies, I2 = 0%), cerebral palsy and/or epilepsy (ORobs 1·78, 1·18-2·69; one study), epilepsy alone (ORobs 2·02, 1·30-3·14, one study; ORRCT 1.03, 0.79-1.35, two studies), and gastrointestinal malformations (ORobs 1·56, 1·05-2·32, two studies) compared with alternative antibiotics. We found no evidence of an adverse effect on 12 other malformations, stillbirth, or neonatal death. Results

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2019 PLoS ONE

3. Antibiotics for asymptomatic bacteriuria in pregnancy. (PubMed)

Antibiotics for asymptomatic bacteriuria in pregnancy. Asymptomatic bacteriuria occurs in 2% to 10% of pregnancies and, if not treated, up to 30% of mothers will develop acute pyelonephritis. Asymptomatic bacteriuria has been associated with low birthweight and preterm birth.To assess the effect of antibiotic treatment for asymptomatic bacteriuria on the development of pyelonephritis and the risk of low birthweight and preterm birth.We searched the Cochrane Pregnancy and Childbirth Group's (...) primary outcomes were assessed with GRADE software and given a quality rating. Evidence for pyelonephritis, preterm birth and birthweight less than 2500 g was assessed as of low or very low quality.While antibiotic treatment is effective in reducing the risk of pyelonephritis in pregnancy, the estimate of the effect is very uncertain because of the very low quality of the evidence. The reduction in low birthweight and preterm birth with antibiotic treatment is consistent with theories about the role

2015 Cochrane

4. Antibiotic prophylaxis during the second and third trimester to reduce adverse pregnancy outcomes and morbidity. (PubMed)

Antibiotic prophylaxis during the second and third trimester to reduce adverse pregnancy outcomes and morbidity. Several studies have suggested that prophylactic antibiotics given during pregnancy improved maternal and perinatal outcomes, while others have shown no benefit and some have reported adverse effects.To determine the effect of prophylactic antibiotics on maternal and perinatal outcomes during the second and third trimester of pregnancy for all women or women at risk of preterm (...) delivery.We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 April 2015) and reference lists of retrieved articles.Randomised controlled trials comparing prophylactic antibiotic treatment with placebo or no treatment for women in the second or third trimester of pregnancy before labour.We assessed trial quality and extracted data.The review included eight randomised controlled trials. Approximately 4300 women were recruited to detect the effect of prophylactic antibiotic

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2015 Cochrane

5. Prevalence of time-related bias in pharmacoepidemiology studies on the use of anti-emetics, antifungal, and antibiotic medications during pregnancy: a systematic review

Prevalence of time-related bias in pharmacoepidemiology studies on the use of anti-emetics, antifungal, and antibiotic medications during pregnancy: a systematic review Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability

2019 PROSPERO

6. Use of antibiotics during pregnancy and risk of spontaneous abortion (PubMed)

Use of antibiotics during pregnancy and risk of spontaneous abortion Although antibiotics are widely used during pregnancy, evidence regarding their fetal safety remains limited. Our aim was to quantify the association between antibiotic exposure during pregnancy and risk of spontaneous abortion.We conducted a nested case-control study within the Quebec Pregnancy Cohort (1998-2009). We excluded planned abortions and pregnancies exposed to fetotoxic drugs. Spontaneous abortion was defined (...) as having a diagnosis or procedure related to spontaneous abortion before the 20th week of pregnancy. The index date was defined as the calendar date of the spontaneous abortion. Ten controls per case were randomly selected and matched by gestational age and year of pregnancy. Use of antibiotics was defined by filled prescriptions between the first day of gestation and the index date and was compared with (a) non-exposure and (b) exposure to penicillins or cephalosporins. We studied type of antibiotics

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2017 EvidenceUpdates

7. Association between antibiotic treatment during pregnancy & infancy and the development of allergic diseases. (PubMed)

Association between antibiotic treatment during pregnancy & infancy and the development of allergic diseases. Allergies are a serious public health issue, and prevalences are rising worldwide. The role of antibiotics in the development of allergies has repeatedly been discussed, as results remain inconsistent. The aim of this study was to investigate the association between pre- and post-natal antibiotic exposure and subsequent development of allergies (atopic dermatitis, food allergy, asthma (...) , atopic sensitization and allergic rhinitis).A total of 1080 children who participated in a European birth cohort study (PASTURE) were included in this analysis. Data on antibiotic exposure during pregnancy and/or first year of life and allergic diseases were collected by questionnaires from pregnancy up to 6 years of age and analysed by performing logistic regressions. To take into account reverse causation, we included models, where children with diagnosis or symptoms of the respective disease

2019 Pediatric Allergy and Immunology

8. Maternal antibiotic use during pregnancy and childhood obesity at age 5 years. (PubMed)

Maternal antibiotic use during pregnancy and childhood obesity at age 5 years. The benefits of antibiotic treatment during pregnancy are immediate, but there may be long-term risks to the developing child. Prior studies show an association between early life antibiotics and obesity, but few have examined this risk during pregnancy.To evaluate the association of maternal antibiotic exposure during pregnancy on childhood BMI-z at 5 years, we conducted a retrospective cohort analysis. Using (...) electronic health record data from seven health systems in PCORnet, a national distributed clinical research network, we included children with same-day height and weight measures who could be linked to mothers with vital measurements during pregnancy. The primary independent variable was maternal outpatient antibiotic prescriptions during pregnancy (any versus none). We examined dose response (number of antibiotic episodes), spectrum and class of antibiotics, and antibiotic episodes by trimester

2019 International Journal of Obesity

9. Urinary tract infections and antibiotic use in pregnancy - qualitative analysis of online forum content. (PubMed)

Urinary tract infections and antibiotic use in pregnancy - qualitative analysis of online forum content. Antibiotics are standard treatment for asymptomatic and symptomatic urinary tract infections (UTIs) in pregnancy. Their overuse, however, can contribute to antimicrobial resistance (AMR) and expose the foetus to drugs that might affect its development. Preventative behaviours are currently the best option to reduce incidences of UTIs and to avoid the use of antibiotics in pregnancy. The aim (...) thematic analysis.Women's perceptions of UTIs and antibiotic use in pregnancy were driven by their pre-natal attachment to the foetus. UTIs were thought to be common and high risk in pregnancy, which meant that antibiotics were viewed as essential in the presence of suspected symptoms. The dominant view about antibiotics was that their use was safe and of little concern in pregnancy. Women reported an emotional reaction to developing a UTI. They coped by seeking information about behaviour change

2019 BMC Pregnancy and Childbirth

10. A systematic review of non-antibiotic measures for the prevention of urinary tract infections in pregnancy. (PubMed)

A systematic review of non-antibiotic measures for the prevention of urinary tract infections in pregnancy. Urinary tract infections (UTIs) are common in pregnancy and account for the highest proportion of primary care antibiotic prescriptions issued to pregnant women in the UK. It is well known that antibiotic use is associated with increased antimicrobial resistance and therefore measures to minimise antibiotic use for UTI prevention have been studied. The efficacy and safety (...) of these measures in pregnancy have not been addressed and therefore the aim of this study was to systematically review the literature to identify and evaluate potential measures to prevent UTIs in pregnant women.Ten databases (EMBASE, AMED, BNI, CINAHL, Medline, PubMed, PsycINFO, Cochrane Trials, Scopus and Science Direct) were systematically searched in July 2017 for studies reporting non-antibiotic measures to prevent UTIs in pregnancy. The terms ("urinary tract infection" or UTI or bacteriuria or cystitis

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2018 BMC Pregnancy and Childbirth

11. Antibiotics in Pregnancy Increase Children's Risk of Otitis Media and Ventilation Tubes. (PubMed)

Antibiotics in Pregnancy Increase Children's Risk of Otitis Media and Ventilation Tubes. To study the association between antibiotic intake in pregnancy and the development of otitis media and placement of ventilation tubes (VTs) in the offspring under the hypothesis that antibiotics in pregnancy may alter the offspring's propensity for disease.Data from the 700 children in the Copenhagen Prospective Studies on Asthma in Childhood 2010 unselected birth cohort study were used. Information (...) on maternal antibiotic use and other exposures during pregnancy was collected prospectively from interviews and validated in national registries. Otitis media episodes were registered in a prospective diary for 3 years. Information regarding children's VTs was obtained from national registries.There were 514 children who had diary information and were included in the analysis regarding otitis media episodes. For VTs analysis, 699 children were included. Thirty-seven percent of the mothers received

2017 Journal of Pediatrics

12. Outcomes of antibiotic therapy for uncomplicated appendicitis in pregnancy. (PubMed)

Outcomes of antibiotic therapy for uncomplicated appendicitis in pregnancy. The aim of the present study is to determine the feasibility and safety of antibiotics for uncomplicated simple appendicitis in pregnancy.We conducted a 6-year prospective observational study on 20 pregnant women in whom uncomplicated simple appendicitis (appendiceal diameter ≤11 mm and with no signs of appendicoliths, perforation, or abscess) was radiologically verified and managed with a 4-day course of antibiotics (...) . Treatment failure rate, defined as the need for an appendectomy during hospitalization and recurrence in the follow-up period (median 25 months), and maternal or fetal complications during the pregnancy were evaluated.Mean age of patients was 33.4 years, and gestational age was 17.8 weeks. Three patients failed to respond to antibiotic therapy during hospitalization and underwent subsequent appendectomy (2 suppurative and 1 perforated appendicitis). There was 1 wound infection postoperatively. During

2017 American Journal of Medicine

14. Optimal levels of DHEA for pregnancy may be reduced by antibiotics (PubMed)

Optimal levels of DHEA for pregnancy may be reduced by antibiotics 28760838 2017 10 16 2018 12 02 1488-2329 189 30 2017 07 31 CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne CMAJ Optimal levels of DHEA for pregnancy may be reduced by antibiotics. E999 10.1503/cmaj.733105 Howard James M JM Independent biologist, Fayetteville, Ark. eng Letter Comment Canada CMAJ 9711805 0820-3946 0 Anti-Bacterial Agents 459AG36T1B Dehydroepiandrosterone AIM IM CMAJ. 2017 (...) May 1;189(17 ):E625-E633 28461374 CMAJ. 2017 Jul 31;189(30):E1000 28760839 Anti-Bacterial Agents Dehydroepiandrosterone Female Fertilization in Vitro Humans Pregnancy Competing interests: None declared. 2017 8 2 6 0 2017 8 2 6 0 2017 10 17 6 0 ppublish 28760838 189/30/E999 10.1503/cmaj.733105 PMC5536992 Reprod Biol Endocrinol. 2009 Oct 07;7:108 19811650 Riv Biol. 2001 Jan-Apr;94(1):177-83 11445999 Gynecol Endocrinol. 2013 Oct;29(10):940-3 23889217 CMAJ. 2017 May 1;189(17 ):E625-E633 28461374 Brain

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2017 CMAJ : Canadian Medical Association Journal

15. Use of antibiotics during pregnancy and the risk of major congenital malformations: a population based cohort study (PubMed)

Use of antibiotics during pregnancy and the risk of major congenital malformations: a population based cohort study Few studies have investigated the link between individual antibiotics and major congenital malformations (MCMs) including specific malformations owing to small sample size. We aimed to quantify the association between exposure to gestational antibiotic and the risk of MCMs.Using the Quebec pregnancy cohort (1998-2008), we included a total of 139 938 liveborn singleton alive whose (...) mothers were covered by the "Régie de l'assurance maladie du Québec" drug plan for at least 12 months before and during pregnancy. Antibiotic exposure was assessed in the first trimester and MCMs were identified within the first year of life.After adjusting for potential confounders, clindamycin exposure was associated with an increased risk of MCMs (aOR 1.34, 95% CI 1.02-1.77, 60 exposed cases), musculoskeletal system malformations (aOR 1.67, 95% CI 1.12-2.48, 29 exposed cases) and ventricular/atrial

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2017 British journal of clinical pharmacology

16. Antibiotic use during pregnancy: a retrospective study of prescription patterns and birth outcomes at an antenatal clinic in rural Ghana (PubMed)

Antibiotic use during pregnancy: a retrospective study of prescription patterns and birth outcomes at an antenatal clinic in rural Ghana Babies are increasingly being exposed to antibiotics intrapartum in the bid to reduce neonatal and maternal deaths. Intrapartum antibiotic exposure, including even those considered safe in pregnancy, have been associated with childhood obesity and compromised immunity. Data on the extent of antibiotic use, safety and its impact on birth outcomes and neonatal (...) health in Sub-Saharan Africa is very limited. This study sought to ascertain the extent of antibiotic use in pregnancy and its effects on birth outcomes in a rural hospital in Ghana.The study was a retrospective randomized study of mothers who delivered babies in a rural hospital between 2011 and 2015 in Ghana. A total of 412 mother/baby records out of 2100 pre-selected met the inclusion criteria of the study. Indicators of neonatal health used were birthweight, Apgar score, incidence of birth

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2017 Journal of pharmaceutical policy and practice

17. Proposals for a more effective antibiotic policy in Belgium

Proposals for a more effective antibiotic policy in Belgium 2019 www.kce.fgov.be KCE REPORT 311 PROPOSALS FOR A MORE EFFECTIVE ANTIBIOTIC POLICY IN BELGIUM 2019 www.kce.fgov.be KCE REPORT 311 HEALTH SERVICES RESEARCH PROPOSALS FOR A MORE EFFECTIVE ANTIBIOTIC POLICY IN BELGIUM ROOS LEROY, WENDY CHRISTIAENS, CHARLINE MAERTENS DE NOORDHOUT, GERMAINE HANQUET COLOPHON Title: Proposals for a more effective antibiotic policy in Belgium Authors: Roos Leroy (KCE), Wendy Christiaens (KCE), Charline (...) of antibiotic use in animals), Frédéric Frippiat (Antibiotics dosage in CHU Liège, funded by CHU Liège), Jacques Mainil (Project FOD – SPF Health Care: Emergence and decline of classical beta-lactamases, of extended spectrum beta lactamases and of carbapenemases amongst coliform bacteria from ruminants: gene identification, antibody neutralization and strain survival), Léonard Théron (Project LAECEA, mastitis epidemic) A grant, fees or funds for a member of staff or another form of compensation

2019 Belgian Health Care Knowledge Centre

18. Is the use of chlorhexidine contributing to increased resistance to chlorhexidine and/or antibiotics?

Is the use of chlorhexidine contributing to increased resistance to chlorhexidine and/or antibiotics? 1 Is the use of chlorhexidine contributing to increased resistance to chlorhexidine and/or antibiotics? Technical Report Prepared for National Health and Medical Research Council (NHMRC) Submitted by University of South Australia Division of Health Sciences Submission date 24th April 2017 2 Contents Page 1. Review Team and Background…………………………..…………………………….….3 2. Methods (...) in ‘chlorhexidine resistance’ within different healthcare settings? 2. Does exposure (different dosages, duration of use, and stratification of exposure) to any form of chlorhexidine increase the incidence and/or prevalence of antibiotic-resistant strains of bacteria in any person within different healthcare settings? Table 1: PICOS overview Question 1 Population and setting Intervention Outcome Types of studies Qu 1 All patients (isolates) / participants (isolates) including children and adults in different

2018 National Health and Medical Research Council

19. The Collaborative Assessment, OTCA12, on “C-reactive protein point-of-care testing (CRP POCT) to guide antibiotic prescribing in primary care settings for acute respiratory tract infections (RTIs)

The Collaborative Assessment, OTCA12, on “C-reactive protein point-of-care testing (CRP POCT) to guide antibiotic prescribing in primary care settings for acute respiratory tract infections (RTIs) Dec2015 © EUnetHTA, 2015. Reproduction is authorised provided EUnetHTA is explicitly acknowledged 1 EUnetHTA Joint Action 3 WP4 Version 1.4, +31 January 2019] Rapid assessment of other technologies using the HTA Core Model ® for Rapid Relative Effectiveness Assessment C-REACTIVE PROTEIN POINT-OF-CARE (...) TESTING (CRP POCT) TO GUIDE ANTIBIOTIC PRESCRIBING IN PRIMARY CARE SETTINGS FOR ACUTE RESPIRATORY TRACT INFECTIONS (RTIS) Project ID: OTCA012 C-reactive protein point-of-care testing to guide antibiotic prescribing for acute respiratory tract infections in primary care EUnetHTA Joint Action 3 WP4 2 DOCUMENT HISTORY AND CONTRIBUTORS Version Date Description V1.0 26/10/2018 First draft. V1.1 03/12/2018 Input from co-author has been processed. V1.2 03/12/2018 Input from dedicated reviewers has been

2019 EUnetHTA

20. HTA of C-reactive protein point-of-care testing to guide antibiotic prescribing

HTA of C-reactive protein point-of-care testing to guide antibiotic prescribing Health Technology Assessment (HTA) of CRP POCT Health Information and Quality Authority i Health Technology Assessment of C-reactive protein point-of-care testing to guide antibiotic prescribing for acute respiratory tract infections in primary care settings April 2019 Health Technology Assessment (HTA) of CRP POCT Health Information and Quality Authority ii Health Technology Assessment (HTA) of CRP POCT Health (...) a range of health services, in conjunction with the Department of Health and the HSE. Health Technology Assessment (HTA) of CRP POCT Health Information and Quality Authority iv Foreword Antimicrobial resistance occurs when bacteria adapt in response to the use of medicines. When bacteria become antibiotic resistant, infections become more difficult to manage and treat. Antimicrobial resistance is a significant threat to public health, and widely acknowledged to be associated with the excessive

2019 Health Information and Quality Authority

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