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Antibiotics in Pregnancy

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41. Asymptomatic Bacteriuria in Pregnancy

about the benefits and harms of screening. Linked evidence for screening that considers the effectiveness of antibiotic treatment for screen-identified women was also low-quality and suggested that treatment modestly reduces the incidence of pyelonephritis and the number of low birth weight infants. It is a longstanding practice in Canada to provide routine screening and treatment of asymptomatic bacteriuria in pregnancy, and this may contribute to the apparently low prevalence of pyelonephritis (...) bacteriuria in pregnancy recognizes that some women who are not at increased risk of asymptomatic bacteriuria in pregnancy and are more concerned with potential harms of antibiotics may choose not to be screened or treated for asymptomatic bacteriuria. In such circumstances, there is potential value for discussion between clinicians and patients in order to reach evidence informed and values based decisions. This guideline does not apply to women at increased risk of asymptomatic bacteriuria in pregnancy

2018 Canadian Task Force on Preventive Health Care

42. Interventions for treating genital Chlamydia trachomatis infection in pregnancy. (Full text)

Interventions for treating genital Chlamydia trachomatis infection in pregnancy. Genital Chlamydia trachomatis (C.trachomatis) infection may lead to pregnancy complications such as miscarriage, preterm labour, low birthweight, preterm rupture of membranes, increased perinatal mortality, postpartum endometritis, chlamydial conjunctivitis and C.trachomatis pneumonia.This review supersedes a previous review on this topic.To establish the most efficacious and best-tolerated therapy for treatment (...) of genital chlamydial infection in preventing maternal infection and adverse neonatal outcomes.We searched the Cochrane Pregnancy and Childbirth Group's Trials Register, ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform (ICTRP) (26 June 2017) and reference lists of retrieved studies.Randomised controlled trials (RCTs) as well as studies published in abstract form assessing interventions for treating genital C.trachomatis infection in pregnancy. Cluster-RCTs were also eligible

2017 Cochrane

43. Superficial Bacterial Skin Infections - Guidelines for Prescribing Topical Antibiotics for impetigo and folliculitis

Superficial Bacterial Skin Infections - Guidelines for Prescribing Topical Antibiotics for impetigo and folliculitis Superficial Bacterial Skin Infections - Guidelines for Prescribing Topical Antibiotics for impetigo and folliculitis - medSask Home - College of Pharmacy and Nutrition - University of Saskatchewan Toggle Menu Search the U of S Search Superficial Bacterial Skin Infections - Guidelines for Prescribing Topical Antibiotics for impetigo and folliculitis The skin has an effective (...) itchy, papules and/or pustules at the base of the hair shaft. The causative agent is usually aureus . Furuncles or boils usually begin as folliculitis which spreads and forms a tender, red swelling with a central pustule. This may progress to carbuncles, an aggregate of furuncles which penetrates to deeper layers of skin and can lead to cellulitis, a diffuse inflammation of the skin. Furuncles may require systemic antibiotic treatment. For more information and photos, go to: Less severe form

2017 medSask

44. Blood test could shorten antibiotic treatment in newborns with suspected sepsis

Blood test could shorten antibiotic treatment in newborns with suspected sepsis Blood test could shorten antibiotic treatment in newborns with suspected sepsis Discover Portal Discover Portal Blood test could shorten antibiotic treatment in newborns with suspected sepsis Published on 28 November 2017 doi: Measuring procalcitonin levels in newborns with suspected sepsis in the first days of life reduced antibiotic duration by 10 hours compared with standard care. There was no increase (...) in the risk of re-infection or death. Systemic infection can be rapidly life-threatening in newborn babies, so those with risk factors are often treated pre-emptively with intravenous antibiotics. If sepsis is not confirmed by blood culture the decision whether to discontinue antibiotics needs to be made, but results of the blood culture takes time. Procalcitonin is released into the blood in response to inflammation, and low levels may give an earlier indication that there is no serious infection

2019 NIHR Dissemination Centre

45. Screening and Management of Bacterial Vaginosis in Pregnancy

in formulating the guideline. Outcomes Outcomes evaluated include antibiotic treatment efficacy and cure rates, and the influence of the treatment of bacterial vaginosis on the rates of adverse pregnancy outcomes such as preterm labour and delivery and preterm premature rupture of membranes. Evidence Medline, EMBASE, CINAHL, and Cochrane databases were searched for articles, published in English before the end of June 2007 on the topic of bacterial vaginosis in pregnancy. Values The evidence obtained (...) Screening and Management of Bacterial Vaginosis in Pregnancy No. 211-Screening and Management of Bacterial Vaginosis in Pregnancy - Journal of Obstetrics and Gynaecology Canada Email/Username: Password: Remember me Search Terms Search within Search Volume 39, Issue 8, Pages e184–e191 No. 211-Screening and Management of Bacterial Vaginosis in Pregnancy x Mark H. Yudin Correspondence Corresponding Author: Dr. Mark Yudin, Department of Obstetrics and Gynecology, University of Toronto, Toronto

2017 Society of Obstetricians and Gynaecologists of Canada

46. CRACKCast E177 – Acute Complications of Pregnancy

of sexually transmitted diseases, in general, the tetracyclines and quinolones are contraindicated in pregnant patients. Treatment of genital tract infections may be important for preventing preterm labor and decreasing transmission to the infant. PID is very rare in pregnancy and does not occur after the first trimester. Given the risk of endometrial infection in pregnancy and the need to consider other diagnoses, pregnant patients who have suspected PID require hospitalization and IV antibiotics (...) findings, diagnosis is frequently delayed, and the perforation rate may approach 25%. 19) List 3 causes of pain in the RUQ in pregnancy. What is the management of each? Appendicitis = surgery Pyelonephritis / nephrolithiasis = antibiotics / retrieval if needed Liver / gallbladder disease = medical vs surgical management Intrahepatic cholestasis of pregnancy Cholecystitis / cholelithiasis Hepatitis Acute fatty liver (hepatic failure usually in 3rd trimester) Spontaneous intrahepatic hemorrhage 20) List

2018 CandiEM

47. CRACKCast E179 – Drug Therapy in Pregnancy

in pregnancy Antibiotics without known teratogenic effects include: Cephalosporins Penicillins (except the estolate) Augmentin . Though indication and unmeasured confounders could account for results, in a nested case control study including over 95,000 pregnant women, an association between spontaneous abortion and first trimester use of: Macrolides Tetracyclines (excluding erythromycin) Quinolones Sulfonamides Metronidazole Source: UpToDate Avoided agents typically include therefore: Aminoglycosides (...) CRACKCast E179 – Drug Therapy in Pregnancy CRACKCast E179 - Drug Therapy in Pregnancy - CanadiEM CRACKCast E179 – Drug Therapy in Pregnancy In , by Chris Lipp May 21, 2018 This episode of CRACKCast covers Rosen’s Chapter 179, Drug Therapy in Pregnancy. There is a lot of fear and anxiety often present within pharmacologic therapy in pregnancy, but having informed, shared decision making with patients can lead to safer outcomes and adherence when treating. Check out FOAMCast Shownotes – Key

2018 CandiEM

48. Management of Pregnancy

Management of Pregnancy VA/DOD CLINICAL PRACTICE GUIDELINE FOR THE MANAGEMENT OF PREGNANCY Department of Veterans Affairs Department of Defense QUALIFYING STATEMENTS The Department of Veterans Affairs and the Department of Defense guidelines are based upon the best information available at the time of publication. They are designed to provide information and assist decision making. They are not intended to define a standard of care and should not be construed as one. Neither should (...) these guidelines does not guarantee coverage of civilian sector care. Additional information on current TRICARE benefits may be found at www.tricare.mil or by contacting your regional TRICARE Managed Care Support Contractor. Version 3.0 – 2018VA/DoD Clinical Practice Guideline for the Management of Pregnancy March 2018 Page 2 of 147 Prepared by: The Management of Pregnancy Work Group With support from: The Office of Quality, Safety and Value, VA, Washington, DC & Office of Evidence Based Practice, U.S. Army

2018 VA/DoD Clinical Practice Guidelines

49. Early Pregnancy Loss

to that after suction curettage for induced abortion. Therefore, despite the lack of data, antibiotic prophylaxis also should be considered for patients with early pregnancy loss (44, 45). The use of a single preoperative dose of doxycycline is recommended to prevent infection after surgical management of early pregnancy loss. Some ex- perts have recommended administration of a single 200- mg dose of doxycycline 1 hour before surgical manage- ment of early pregnancy loss to prevent postoperative infection (...) . The use of antibiotics based only on the diag- nosis of incomplete early pregnancy loss has not been found to reduce infectious complications as long as unsafe induced abortion is not suspected (46). The ben- efitofantibioticprophylaxisforthemedicalmanagement of early pregnancy loss is unknown. < How do the different treatment approaches to early pregnancy loss differ with respect to cost? Studies have consistently shown that surgical man- agement in an operating room is more costly than expectant

2018 American College of Obstetricians and Gynecologists

50. The relationship between oral health and pregnancy

and of systemic antibiotics is generally safe. However, tetracyclines and metronidazole should be avoided. Medication should be prescribed to the pregnant woman after communication with her obstetrician. Non-surgical periodontal therapy has been shown to be effective in improving the periodontal status of pregnant women with periodontitis. Pregnancy epulis: In the presence of a localised gingival enlargement (pregnancy epulis), surgical excision should be delayed until postpartum and supportive measures (...) The relationship between oral health and pregnancy Guidelines for oral-health professionals THE RELATIONSHIP BETWEEN ORAL HEALTH AND PREGNANCYEuropean Federation of Periodontology3 Guidelines for oral health professionals Introduction The main hormonal changes in a woman’s life take place during pregnancy – and the mouth is one of the main areas affected by such changes. Elevated hormone levels (oestrogen and progesterone) significantly increase vascular permeability in the gingival tissues

2017 British Society of Periodontology

51. Prophylactic antibiotics to reduce pelvic infection in women having miscarriage surgery – The AIMS (Antibiotics in Miscarriage Surgery) trial: study protocol for a randomized controlled trial (Full text)

Prophylactic antibiotics to reduce pelvic infection in women having miscarriage surgery – The AIMS (Antibiotics in Miscarriage Surgery) trial: study protocol for a randomized controlled trial The estimated annual global burden of miscarriage is 33 million out of 210 million pregnancies. Many women undergoing miscarriage have surgery to remove pregnancy tissues, resulting in miscarriage surgery being one of the most common operations performed in hospitals in low-income countries. Infection (...) is a serious consequence and can result in serious illness and death. In low-income settings, the infection rate following miscarriage surgery has been reported to be high. Good quality evidence on the use of prophylactic antibiotics for surgical miscarriage management is not available. Given that miscarriage surgery is common, and infective complications are frequent and serious, prophylactic antibiotics may offer a simple and affordable intervention to improve outcomes.Eligible patients

2018 Trials

52. Blood test could shorten antibiotic treatment in newborns with suspected sepsis

Blood test could shorten antibiotic treatment in newborns with suspected sepsis Blood test could shorten antibiotic treatment in newborns with suspected sepsis Discover Portal Discover Portal Blood test could shorten antibiotic treatment in newborns with suspected sepsis Published on 28 November 2017 doi: Measuring procalcitonin levels in newborns with suspected sepsis in the first days of life reduced antibiotic duration by 10 hours compared with standard care. There was no increase (...) in the risk of re-infection or death. Systemic infection can be rapidly life-threatening in newborn babies, so those with risk factors are often treated pre-emptively with intravenous antibiotics. If sepsis is not confirmed by blood culture the decision whether to discontinue antibiotics needs to be made, but results of the blood culture takes time. Procalcitonin is released into the blood in response to inflammation, and low levels may give an earlier indication that there is no serious infection

2018 NIHR Dissemination Centre

53. Routes of administration of antibiotic prophylaxis for preventing infection after caesarean section. (Full text)

of antibiotic prophylaxis for preventing infection after caesarean section.The aim of this review was to assess the benefits and harms of different routes of prophylactic antibiotics given for preventing infectious morbidity in women undergoing caesarean section.We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 January 2016), ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform (ICTRP) (6 January 2016) and reference lists of retrieved studies.We included (...) Routes of administration of antibiotic prophylaxis for preventing infection after caesarean section. Post-caesarean section infection is a cause of maternal morbidity and mortality. Administration of antibiotic prophylaxis is recommended for preventing infection after caesarean delivery. The route of administration of antibiotic prophylaxis should be effective, safe and convenient. Currently, there is a lack of synthesised evidence regarding the benefits and harms of different routes

2016 Cochrane

54. Different antibiotic regimens for treating asymptomatic bacteriuria in pregnancy. (Full text)

Different antibiotic regimens for treating asymptomatic bacteriuria in pregnancy. Asymptomatic bacteriuria occurs in 5% to 10% of pregnancies and, if left untreated, can lead to serious complications.To assess which antibiotic is most effective and least harmful as initial treatment for asymptomatic bacteriuria in pregnancy.We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (March 2010) and reference lists of retrieved studies.Randomized controlled trials comparing two (...) . Comparing cycloserine with sulphadimidine, no significant differences in symptomatic, persistent, or recurrent infections were noted.We cannot draw any definite conclusion on the most effective and safest antibiotic regimen for the initial treatment of asymptomatic bacteriuria in pregnancy. One study showed advantages with a longer course of nitrofurantoin, and another showed better tolerability with ampicillin compared with pivmecillinam; otherwise, there was no significant difference demonstrated

2010 Cochrane

55. A Randomized Trial of Prophylactic Antibiotics for Miscarriage Surgery. (Full text)

of these features and the clinically identified need to administer antibiotics. The definition of pelvic infection was changed before the unblinding of the data; the original strict definition was two or more of the clinical features, without reference to the administration of antibiotics.We enrolled 3412 patients in Malawi, Pakistan, Tanzania, and Uganda. A total of 1705 patients were assigned to receive antibiotics and 1707 to receive placebo. The risk of pelvic infection was 4.1% (68 of 1676 pregnancies (...) ) in the antibiotics group and 5.3% (90 of 1684 pregnancies) in the placebo group (risk ratio, 0.77; 95% confidence interval [CI], 0.56 to 1.04; P = 0.09). Pelvic infection according to original strict criteria was diagnosed in 1.5% (26 of 1700 pregnancies) and 2.6% (44 of 1704 pregnancies), respectively (risk ratio, 0.60; 95% CI, 0.37 to 0.96). There were no significant between-group differences in adverse events.Antibiotic prophylaxis before miscarriage surgery did not result in a significantly lower risk

2019 NEJM Controlled trial quality: predicted high

56. Antibiotic regimens for postpartum endometritis. (PubMed)

Antibiotic regimens for postpartum endometritis. Postpartum endometritis occurs when vaginal organisms invade the endometrial cavity during the labor process and cause infection. This is more common following cesarean birth. The condition warrants antibiotic treatment.Systematically, to review treatment failure and other complications of different antibiotic regimens for postpartum endometritis.We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 November 2014 (...) ) and reference lists of retrieved studies.We included randomized trials of different antibiotic regimens after cesarean birth or vaginal birth; no quasi-randomized trials were included.Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy.The review includes a total of 42 trials, and 40 of these trials contributed data on 4240 participants.Regarding the primary outcomes, seven studies compared clindamycin plus an aminoglycoside versus

2015 Cochrane

57. Guidelines for the Use of Laparoscopy during Pregnancy

Guidelines for the Use of Laparoscopy during Pregnancy Guidelines for the Use of Laparoscopy during Pregnancy - A SAGES Publication Society of American Gastrointestinal and Endoscopic Surgeons Guidelines for the Use of Laparoscopy during Pregnancy This document was reviewed and approved by the Board of Governors of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) in May 2017. Authors Jonathan P Pearl, Raymond R Price, Allison E Tonkin, William S Richardson, Dimitrios (...) Stefanidis Preamble Surgical interventions during pregnancy should minimize fetal risk without compromising the safety of the mother. Favorable outcomes for the pregnant woman and fetus depend on accurate and timely diagnosis with prompt intervention. Surgeons must be aware of data regarding differences in techniques used for pregnant patients to optimize outcomes. This document provides specific recommendations and guidelines to assist physicians in the diagnostic work-up and treatment of surgical

2017 Society of American Gastrointestinal and Endoscopic Surgeons

58. Flowchart: Stable intrauterine non-viable pregnancy

Flowchart: Stable intrauterine non-viable pregnancy Queensland Health State of Queensland (Queensland Health) 2017 http://creativecommons.org/licenses/by-nc-nd/3.0/au/deed.en Queensland Clinical Guidelines, Guidelines@health.qld.gov.au Queensland Clinical Guidelines www.health.qld.gov.au/qcg Stable intrauterine non-viable pregnancy Expectant Indications • Woman’s preference • Incomplete miscarriage Contraindications • Haemodynamic instability • Suspected GTD • IUD (must be removed) • Risk (...) • Persistent excess bleeding • Evidence of infected POC • Suspected GTD Cautions • Risk of haemorrhage or effects of haemorrhage • Previous uterine perforation Care provision • Misoprostol for cervical priming • Routine antibiotics not required • USS at time of suction curettage (if indicated) Follow-up • GP if ongoing concerns • ß-hCG not routinely indicated • USS not routinely indicated Surgical Give written information about: • Management option chosen • Expected bleeding/symptoms • Resumption

2017 Queensland Health

59. Early pregnancy loss

suspected, recommend early surgical management with antibiotic cover • Recommend urinary pregnancy test at 3–6 weeks if 9 2 : o No POC histopathology o Failure to return to normal menstruation by 4–6 weeks o Ongoing abnormal bleeding Advice for women • Refer to Section 1.2 for information/advice requirements • Access to a telephone and 24 hour emergency hospital admission is required or a plan for access where there is geographical/social isolation 2,7 • Expect bleeding for up to two weeks (or longer (...) evacuation and minimise risk of Asherman’s syndrome o Administer antibiotics *Refer to the Australian pharmacopeia for complete drug information Refer to online version, destroy printed copies after use Page 21 of 39 Queensland Clinical Guideline: Early pregnancy loss 6 Second trimester pregnancy loss Second trimester pregnancy loss represents one to two percent of recognised pregnancies. 54 A cause and effect relationship is difficult to establish and there may be multiple contributing pathologies

2017 Queensland Health

60. Management of Pregnancy in Patients With Complex Congenital Heart Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association (Full text)

Management of Pregnancy in Patients With Complex Congenital Heart Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association Management of Pregnancy in Patients With Complex Congenital Heart Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association | Circulation Search Hello Guest! Login to your account Email Password Keep me logged in Search March 2019 March 2019 March 2019 March 2019 March 2019 February 2019 February (...) 2019 February 2019 February 2019 January 2019 January 2019 January 2019 January 2019 January 2019 Free Access article Share on Jump to Free Access article Management of Pregnancy in Patients With Complex Congenital Heart Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association , RN, MN, FAHA, Chair , MD, FRCP, Co-Chair , MD , MD , MD , MD, DPhil , MD, FAHA, FRCPC , MD , and MD, FRCPC MD, FAHAOn behalf of the American Heart Association Council

2017 American Heart Association

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