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Antibiotics in Pregnancy

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81. Awareness and risk perception of antimicrobial use among pregnant women: A mixed method systematic review protocol

Awareness and risk perception of antimicrobial use among pregnant women: A mixed method systematic review protocol 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 for the content of this registration record, any associated

2020 PROSPERO

82. Chronic obstructive pulmonary disease: Antibiotics

Chronic obstructive pulmonary disease: Antibiotics Antibiotics | Prescribing information | Chronic obstructive pulmonary disease | CKS | NICE Search CKS… Menu Antibiotics Chronic obstructive pulmonary disease: Antibiotics Last revised in November 2019 Antibiotics Azithromycin Contraindications and cautions Do not prescribe azithromycin in people: With severe hepatic impairment. Prescribe azithromycin with caution in people: Who may be predisposed to prolongation of the QT interval. For example (...) any muscle pain, tenderness, or weakness. Typhoid vaccine — antibacterials might reduce the immune response. The World Health Organization (WHO) recommends that the antibacterial is stopped from 3 days before to 3 days after receiving live oral typhoid vaccine. Warfarin — concurrent use may increase the international normalized ratio (INR). Consider increasing INR monitoring as this interaction appears to develop over the first 7 days. Drugs that prolong the QT interval (such as amiodarone

2020 NICE Clinical Knowledge Summaries

83. 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 (...) The Society of Obstetricians and Gynaecologists of Canada. Recommendations There is currently no consensus as to whether to screen for or treat bacterial vaginosis in the general pregnant population in order to prevent adverse outcomes, such as preterm birth. 1. In symptomatic pregnant women, testing for and treatment of bacterial vaginosis is recommended for symptom resolution. Diagnostic criteria are the same for pregnant and non-pregnant women (I-A). 2. Treatment with either oral or vaginal antibiotics

2017 Society of Obstetricians and Gynaecologists of Canada

84. Management of Pregnancy

Health System,” by facilitating the development of clinical practice guidelines (CPGs) for the VA and DoD populations.[ ] This CPG is intended to provide healthcare providers with a framework by which to evaluate, treat, and manage the individual needs and preferences of pregnant women, thereby leading to improved clinical outcomes. 1 In 2009, the VA and DoD published a CPG for the Management of Pregnancy (2009 Pregnancy CPG), which was based on evidence reviewed through December 2007. Since (...) the release of that guideline, a growing body of research has expanded the general knowledge and understanding of pregnancy and its management. Consequently, a recommendation to update the 2009 Pregnancy CPG was initiated in 2016. The updated CPG includes objective, evidence-based information on the management of pregnancy. It is intended to assist healthcare providers in all aspects of care for a pregnant woman. The system-wide goal of developing evidence-based guidelines is to improve patients' health

2018 VA/DoD Clinical Practice Guidelines

85. 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 (...) health care providers assess the benefits and risks in counseling pregnant and nursing women who are taking medications. The rule requires the removal of letter categories and mandates labeling that includes a summary of risks of drug use during pregnancy and lactation, a discussion of the data supporting that summary, and any relevant information to help health care providers make informed decisions and counsel patients. Drugs already approved before this rule will be phased in gradually. So, when

2018 CandiEM

86. 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 (...) , and occasional maternal infections. Approximately 80% of miscarriages occur during the first trimester; the rest occur before 20 weeks of gestation. Approximately 25% of clinically pregnant patients experience some bleeding. It is estimated that up to 50% of all women who have bleeding during early pregnancy miscarry, although the risk is probably higher in the emergency department (ED) population. Important to discuss with most women that usually fetuses are non-viable 1-2 weeks before the bleeding occurs

2018 CandiEM

87. 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

88. 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 (...) of pregnancy most probably does not alter the incidence of preterm birth and low birth weight. However, a positive effect of periodontal intervention in decreasing rates of preterm birth and low birth weight may occur in women who are at high risk of adverse pregnancy outcomes. These trials have shown that non-surgical periodontal therapy during pregnancy is safe for both the mother and the foetus, and that it improves the periodontal status of most pregnant women with periodontal disease, although falling

2017 British Society of Periodontology

89. Nausea/vomiting in pregnancy: Scenario: Management

Nausea/vomiting in pregnancy: Scenario: Management Scenario: Management | Management | Nausea/vomiting in pregnancy | CKS | NICE Search CKS… Menu Scenario: Management Nausea/vomiting in pregnancy: Scenario: Management Last revised in February 2020 Scenario: Management From age 13 years to 60 years (Female). What assessment is required? Enquire about: The onset, duration, and frequency of nausea and vomiting. Whether food and drinks are being tolerated. Associated symptoms (for example weight (...) loss, abdominal pain). Any co-existing conditions (for example diabetes) which may be adversely affected by nausea and vomiting. The effect on the woman's life (for example work, home situation and support, ability to care for her family). The effect on the woman's mood, with further assessment if appropriate. If there are concerns that the woman is showing signs of depression, see the CKS topic on . Consider using a validated questionnaire to assess the severity of nausea and vomiting in pregnancy

2018 NICE Clinical Knowledge Summaries

90. Nausea/vomiting in pregnancy: Cyclizine

Nausea/vomiting in pregnancy: Cyclizine Cyclizine | Prescribing information | Nausea/vomiting in pregnancy | CKS | NICE Search CKS… Menu Cyclizine Nausea/vomiting in pregnancy: Cyclizine Last revised in February 2020 Cyclizine What dosage of cyclizine should I prescribe? Prescribe cyclizine 50 mg orally up to three times a day. [ ; ; ; ] What are the adverse effects of cyclizine? Drowsiness is a significant adverse effect with most of the older antihistamines (such as cyclizine), especially (...) , such as opioid analgesics. Ototoxic drugs — cyclizine may disguise signs indicating the onset of damage caused by ototoxic drugs (such as aminoglycoside antibiotics). [ ; ] © .

2018 NICE Clinical Knowledge Summaries

91. Nausea/vomiting in pregnancy

Nausea/vomiting in pregnancy Nausea/vomiting in pregnancy | Topics A to Z | CKS | NICE Search CKS… Menu Nausea/vomiting in pregnancy Nausea/vomiting in pregnancy Last revised in February 2020 The majority of women vomit or feel nauseated in early pregnancy. Symptoms usually begin between the fourth and seventh weeks of gestation Diagnosis Management Prescribing information Background information Nausea/vomiting in pregnancy: Summary The majority of women vomit or feel nauseated in early (...) pregnancy. Symptoms usually begin between the fourth and seventh weeks of gestation and usually resolve around the 20th week of pregnancy. Hyperemesis gravidarum is a diagnosis of exclusion characterized by prolonged and severe nausea and vomiting, dehydration, electrolyte imbalance, ketonuria, and body weight loss of more than 5% of pre-pregnancy weight. Findings which may suggest an alternative diagnosis include: Onset of symptoms after 11 weeks of gestation. Abdominal pain or tenderness (more than

2018 NICE Clinical Knowledge Summaries

92. Prevalence and determinants of antibiotic use among women who are pregnant living in low and middle income countries

Prevalence and determinants of antibiotic use among women who are pregnant living in low and middle income countries 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. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith" or "Joanne") for correspondence

2018 PROSPERO

93. Antibiotic use and the risk of maternal pregnancy-related complications - a systematic review

Antibiotic use and the risk of maternal pregnancy-related complications - 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. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith" or "Joanne") for correspondence: Organisation web address

2017 PROSPERO

94. Different antibiotic regimens for treating asymptomatic bacteriuria in pregnancy. Full Text available with Trip Pro

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

95. COVID-19 and Pregnant Patients

for COVID-19 infection for COVID-19 in pregnant patients is similar to that in the general population follow in the management of pregnant women with suspected or confirmed COVID-19 management of infection in pregnancy in women with suspected or confirmed COVID-19 there is , but supportive care may help to relieve symptoms and should include support of vital organ functions in severe cases consider of pregnant women during COVID-19 pandemic during COVID-19 pandemic unless directed otherwise by local (...) restriction all pregnant women with suspected or confirmed COVID-19 infection should receive prophylactic low molecular weight heparin upon admission to reduce risk of unless birth is expected within 12 hours for pregnancies with suspected or confirmed COVID-19 between 24 0/7 weeks and 33 6/7 weeks gestation at risk of preterm birth within 7 days, antenatal corticosteroids should continue to be offered as recommended for pregnancies between 34 0/7 and 36 6/7 weeks gestation at risk of preterm birth within

2020 DynaMed Plus

96. Sinusitis (acute): antimicrobial prescribing

Background 5 Recommendations 6 1.1 Managing acute sinusitis 6 1.2 Choice of antibiotic 8 1.3 Self-care 10 Symptoms and signs 12 Common symptoms and signs 12 Factors that might make a bacterial cause more likely 12 Summary of the evidence 13 Self-care 13 Nasal corticosteroids 14 No antibiotic 15 Back-up antibiotics 17 Choice of antibiotic 18 Antibiotic course length 21 Other considerations 23 Medicines adherence 23 Resource implications 23 Sinusitis (acute): antimicrobial prescribing (NG79) © NICE 2019 (...) . All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 3 of 24Ov Overview erview This guideline sets out an antimicrobial prescribing strategy for acute sinusitis. It aims to limit antibiotic use and reduce antimicrobial resistance. Acute sinusitis is usually caused by a virus, lasts for about 2 to 3 weeks, and most people get better without antibiotics. Withholding antibiotics rarely leads to complications. See a 2-page visual

2017 National Institute for Health and Clinical Excellence - Clinical Guidelines

97. Antimicrobial stewardship: changing risk-related behaviours in the general population

Behavioural strategies and programmes 42 3 High-risk groups 42 4 Workplace 43 5 Older people in day and residential care 43 Antimicrobial stewardship: changing risk-related behaviours in the general population (NG63) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 4 of 44Ov Overview erview This guideline covers making people aware of how to correctly use antimicrobial medicines (including antibiotics) and the dangers (...) section on NHS Choices] or there is a high risk of travellers' diarrhoea). The following recommendations are for local authority public health teams. 1.2.4 Consider linking to awareness-raising initiatives for the public on reducing inappropriate antimicrobial demand and use and antimicrobial resistance (for example, European Antibiotic Awareness Day and Public Health England's Antibiotic Guardian). 1.2.5 Use opportunities that may arise through other local authority activities to distribute

2017 National Institute for Health and Clinical Excellence - Clinical Guidelines

98. A Randomized Trial of Prophylactic Antibiotics for Miscarriage Surgery. Full Text available with Trip Pro

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

99. Prescription of macrolides vs penicillin during pregnancy was linked to major malformations in offspring. (Abstract)

Prescription of macrolides vs penicillin during pregnancy was linked to major malformations in offspring. Fan H, Gilbert R, O'Callaghan F, Li L. Associations between macrolide antibiotics prescribing during pregnancy and adverse child outcomes in the UK: population based cohort study. BMJ. 2020;368:m331. 32075790.

2020 Annals of Internal Medicine

100. Neonatal infection: antibiotics for prevention and treatment

to prevent early- onset neonatal infection for women who have had: a previous baby with an invasive group B streptococcal infection group B streptococcal colonisation, bacteriuria or infection in the current pregnancy. Investigations before starting antibiotics in the baby Measure the C-reactive protein concentration at presentation when starting antibiotic treatment in babies with risk factors for infection or clinical indicators of possible infection. Antibiotics for suspected infection Use intravenous (...) them if no problems are anticipated take account of parents' and carers' concerns when providing information and planning follow-up. 1.1.1.11 When a baby who has had a group B streptococcal infection is discharged from hospital: advise the woman that if she becomes pregnant again: there will be an increased risk of early-onset neonatal infection she should inform her maternity care team that a previous baby has had a group B streptococcal infection Neonatal infection (early onset): antibiotics

2012 National Institute for Health and Clinical Excellence - Clinical Guidelines

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