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Antibiotics in Pregnancy

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81. WHO recommendations on antenatal care for a positive pregnancy experience

WHO recommendations on antenatal care for a positive pregnancy experience WHO recommendations on antenatal care for a positive pregnancy experienceWHO Library Cataloguing-in-Publication Data WHO recommendations on antenatal care for a positive pregnancy experience. I.World Health Organization. ISBN 978 92 4 154991 2 Subject headings are available from WHO institutional repository © World Health Organization 2016 All rights reserved. Publications of the World Health Organization are available (...) of declarations of interest from the Guideline Development Group (GDG) members and how they were managed 143 Annex 4: Implementation considerations for ANC guideline recommendations 145 Web annexes: WHO recommendations on antenatal care for a positive pregnancy experience* Web annex 1: Priority questions and outcomes for the antenatal care (ANC) interventions identified for this guideline Web annex 2: Changes from the approved scope of this guideline Web annex 3: Guideline Development Group (GDG) judgements

2016 World Health Organisation Guidelines

82. Induction of labour within 24 hours, if waters break at 37 weeks of pregnancy, can reduce womb infection

Induction of labour within 24 hours, if waters break at 37 weeks of pregnancy, can reduce womb infection Induction of labour within 24 hours, if waters break at 37 weeks of pregnancy, can reduce womb infection Discover Portal Discover Portal Induction of labour within 24 hours, if waters break at 37 weeks of pregnancy, can reduce womb infection Published on 23 May 2017 doi: Inducing labour may halve the risk of infection in the womb when waters break from 37 weeks. The procedure was started (...) ? Premature rupture of membranes (PROM) at full term (37 weeks or more) occurs in 8% of pregnancies. Spontaneous onset of labour within 24 hours occurs in approximately 95% of cases. Labour can be delayed for up to seven days if it does not start within 24 hours. The risk of maternal or neonatal infection and the need for caesarean section are increased by PROM. Untreated infections can lead to complications with reproductive organs, problems with fertility and general health. PROM at term is managed

2018 NIHR Dissemination Centre

83. Liver Disease and Pregnancy

Liver Disease and Pregnancy nature publishing group 1 © 2016 by the American College of Gastroenterology The American Journal of GASTROENTEROLOGY PRACTICE GUIDELINES To determine the level of evidence, the results from the selected papers with the greatest level of evidence were extrapolated and utilized in the GRADE program ( h t t p://w w w .gradep r o .o r g ). A summary of the recommendations are outlined in Table 1 . EVALUATION OF THE PREGNANT PATIENT WITH ABNORMAL LIVER ENZYMES (...) Recommendations: 1. A pregnant patient presenting with abnormal liver tests should undergo standard workup as with any non-pregnant individual (strong recommendation, very low level of evidence). Th e basis for the workup of abnormal liver tests in a pregnant woman should be predicated on understanding the normal physi- ological changes observed during pregnancy. Th e incidence of abnormal liver tests in pregnant women is ~3–5%, even in this relatively young and healthy population. Some liver test results

2016 American College of Gastroenterology

84. Hypertension in pregnancy

Hypertension in pregnancy Hypertension in pregnancy - NICE CKS Share Hypertension in pregnancy: Summary Several different hypertensive disorders can complicate pregnancy. The National Institute for Health and Clinical Excellence (NICE) uses the following working definitions. Hypertension during pregnancy A diastolic blood pressure of 90 mmHg or greater on two occasions more than 4 hours apart, and/or A single diastolic blood pressure greater than 110 mmHg. Mild, moderate, and severe (...) the first and second trimesters and a woman with a high blood pressure before week 20 of pregnancy can therefore be assumed to have pre-existing hypertension. Gestational hypertension New hypertension presenting after 20 weeks' gestation without significant proteinuria. Pre-eclampsia New hypertension presenting after 20 weeks' gestation with significant proteinuria. Pre-eclampsia is a multi-system disorder which can affect the placenta, kidney, liver, brain, and other organs of the mother. HELLP

2019 NICE Clinical Knowledge Summaries

85. Safety Profile of Drug Use During Pregnancy at Peripheral Health Centres in Burkina Faso: A Prospective Observational Cohort Study (PubMed)

by study participants and 36.6, 49.5 and 13.9% were, respectively, classified as 'probably safe', 'potentially risky' and 'unclassified'. Antimalarials and antibiotics were the most frequently used drugs. Around 39% of women used a least one medication classified as potentially risky. However, this proportion dropped to 26% with the modified classification. Living in urban areas and attending the first antenatal care within their first trimester of pregnancy (longer health surveillance) were associated (...) Safety Profile of Drug Use During Pregnancy at Peripheral Health Centres in Burkina Faso: A Prospective Observational Cohort Study Safety data of many drugs used during pregnancy remain scarce. This is especially true in developing countries characterised by the absence of a robust pharmacovigilance system, high prevalence of different tropical diseases affecting patients and potential for drug-drug interactions. This study aimed to assess the safety profile of drugs used in women at high risk

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2018 Drugs - real world outcomes

86. Antibiotic treatment for patients with amniotic fluid "sludge" to prevent spontaneous preterm birth: a historically controlled observational study. (PubMed)

preterm birth at <34 weeks. The objective of this study was to evaluate routine antibiotic treatment in the presence of amniotic fluid "sludge" for prevention of preterm delivery.A historically-controlled observational study was performed between October 2010 and January 2015, including a total of 86 pregnant women with singleton pregnancies and the presence of amniotic fluid "sludge" at ultrasound. Women admitted from October 2010 to September 2012 received no treatment with antibiotics, whereas (...) Antibiotic treatment for patients with amniotic fluid "sludge" to prevent spontaneous preterm birth: a historically controlled observational study. Amniotic fluid "sludge" has been associated with an increased rate of spontaneous preterm delivery before 35 weeks, a higher frequency of clinical chorioamnionitis, and histologic chorioamnionitis in a high-risk population. Only one study evaluating the use of antibiotics in the presence of amniotic fluid "sludge" showed reduced rates of spontaneous

2019 Acta Obstetricia et Gynecologica Scandinavica

87. The association between antibiotics in the first year of life and child growth trajectory. (PubMed)

) and 6 year follow-up study (6YFU) were included. Antibiotic exposures, weight and height measurements were collected from birth through the first 12 months, and then again at 6 years. Linear mixed effects growth modeling, controlling for exclusive breastfeeding, socio-demographic factors, smoking during pregnancy, gestational diabetes, and maternal pre-pregnancy weight status, was used to examine the association between antibiotic exposure and child growth trajectories through age 6 years.The (...) The association between antibiotics in the first year of life and child growth trajectory. Antibiotics are frequently prescribed to children, and may be an environmental influence that contributes to the increasing prevalence of childhood obesity. The aim of this study was to examine the effect of antibiotic use in the first year of life on child growth trajectories from birth to age 6 years including significant covariates.Data from 586 children in the Infant Feeding Practices II (IFPS II

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2019 BMC Pediatrics

88. Evidence that antibiotic administration is effective in the treatment of a subset of patients with intra-amniotic infection/inflammation presenting with cervical insufficiency. (PubMed)

cerclage is performed. The use of prophylactic antibiotics is predicated largely on the basis that they reduce the rate of complications during the course of vaginal surgery. However, it is possible that antibiotic administration can also eradicate intra-amniotic infection/inflammation and improve pregnancy outcome.To describe the outcome of antibiotic treatment of patients with cervical insufficiency with either intra-amniotic infection/inflammation.The study population consisted of 22 women who met (...) the following criteria: 1) singleton pregnancy; 2) painless cervical dilatation of >1cm between 16.0-27.9 weeks of gestation; 3) intact membranes and absence of uterine contractions; 4) transabdominal amniocentesis performed for the evaluation of the microbiologic and inflammatory status of the amniotic cavity; 5) presence of intra-amniotic infection/inflammation; and 6) antibiotic treatment (regimen consisted of ceftriaxone, clarithromycin, and metronidazole). Amniotic fluid was cultured for aerobic

2019 American Journal of Obstetrics and Gynecology

89. In utero exposure to antibiotics and risk of congenital malformations: A population-based study. (PubMed)

In utero exposure to antibiotics and risk of congenital malformations: A population-based study. Antibiotics are commonly prescribed during pregnancy. While the safety of most penicillins are well established, some controversy and uncertainty are associated with the use of other commonly prescribed antibiotics.To determine the risk of congenital malformations following first trimester in utero exposure to 10 commonly prescribed antibiotics in Denmark.This was a cohort study comprising all (...) antibiotics (excluding four penicillins that served as control). In the primary analysis the exposed cohort were compared to a cohort exposed to either of four penicillins considered safe during pregnancy (ampicillin, pivampicillin, benzylpenicillin ad phenoxymethylpenicillin). In sensitivity analysis, the exposed cohort were compared to an unexposed cohort. Covariate adjustments were made for maternal age at delivery, year of delivery, parity, pre-pregnancy BMI, smoking, educational status, employment

2019 American Journal of Obstetrics and Gynecology

90. An Integrated Safety Summary of Omadacycline, a Novel Aminomethylcycline Antibiotic. (PubMed)

An Integrated Safety Summary of Omadacycline, a Novel Aminomethylcycline Antibiotic. Omadacycline is a semisynthetic tetracycline antibiotic. Phase III clinical trial results have shown that omadacycline has an acceptable safety profile in the treatment of acute bacterial skin and skin structure infections and community-acquired bacterial pneumonia. Similar to most tetracyclines, transient nausea and vomiting and low-magnitude increases in liver aminotransferases were the most frequent (...) treatment-emergent adverse events in phase III studies but were not treatment limiting. Package insert warnings and precautions for omadacycline include tooth discoloration; enamel hypoplasia; inhibition of bone growth following use in late pregnancy, infancy, or childhood up to 8 years of age; an imbalance in mortality (2%, compared with 1% in moxifloxacin-treated patients) was observed in the phase III study in patients with community-acquired bacterial pneumonia. Omadacycline has no effect on the QT

2019 Clinical Infectious Diseases

91. Association of the Eukaryotic Vaginal Virome with Prophylactic Antibiotic Exposure and Reproductive Outcomes in a Subfertile Population Undergoing In Vitro Fertilization: A Prospective Exploratory Study. (PubMed)

, viral diversity was higher in the group that did not achieve clinical pregnancy compared to those who did (p=0.06).We demonstrate the vaginal eukaryotic virome in women undergoing IVF is associated with antibiotic exposure. Additionally, we demonstrate an inverse trend between viral diversity and pregnancy, with a higher number of viruses detected associated with failure to achieve clinical pregnancy in the azithromycin group.© 2019 Royal College of Obstetricians and Gynaecologists. (...) Association of the Eukaryotic Vaginal Virome with Prophylactic Antibiotic Exposure and Reproductive Outcomes in a Subfertile Population Undergoing In Vitro Fertilization: A Prospective Exploratory Study. The objective of this study was to use high-throughput sequencing to describe the vaginal eukaryotic DNA virome in patients undergoing in vitro fertilization (IVF) to examine associations between the vaginal virome, antibiotic exposure, and IVF outcomes.Prospective exploratory study SETTING

2019 BJOG

92. Procalcitonin and lung ultrasonography point-of-care testing to decide on antibiotic prescription in patients with lower respiratory tract infection in primary care: protocol of a pragmatic cluster randomized trial. (PubMed)

, pregnancy, inability to provide informed consent and unavailability of the GP. Patients will fill in a 28 day-symptom diary and will be contacted by phone on days 7 and 28. The primary outcome is the proportion of patients prescribed any antibiotic up to day 28. Secondary outcomes include clinical failure by day 7 (death, admission to hospital, absence of amelioration or worsening of relevant symptoms) and by day 28, duration of restricted daily activities, episode duration as defined by symptom score (...) Procalcitonin and lung ultrasonography point-of-care testing to decide on antibiotic prescription in patients with lower respiratory tract infection in primary care: protocol of a pragmatic cluster randomized trial. A minority of patients presenting with lower respiratory tract infection (LRTI) to their general practitioner (GP) have community-acquired pneumonia (CAP) and require antibiotic therapy. Identifying them is challenging, because of overlapping symptomatology and low diagnostic

2019 BMC pulmonary medicine Controlled trial quality: predicted high

93. Antibiotics for amniotic-fluid colonization by Ureaplasma and/or Mycoplasma spp. to prevent preterm birth: A randomized trial. (PubMed)

Antibiotics for amniotic-fluid colonization by Ureaplasma and/or Mycoplasma spp. to prevent preterm birth: A randomized trial. To assess whether antibiotics used for treatment in asymptomatic second-trimester women positive for Mycoplasma or Ureaplasma spp. detected by amniotic-fluid PCR prevents preterm delivery.A randomized, double-blind, placebo-controlled trial.10 maternal fetal medicine centers in France.Women with a singleton pregnancy who underwent amniocentesis between 16 and 20 weeks (...) total, 1043 women underwent amniotic-fluid screening with specific PCR detection between July 2008 and July 2011: PCR detection failed in 27 (2.6%), and 20 (1.9%) underwent termination of pregnancy. Among the 1016 women with PCR results, 980 had available data for the primary outcome (delivery before 37 weeks) and 29 (3.0%) were positive for Ureaplasma and/or Mycoplasma spp. Because of the low rate of women with PCR-positive findings, the trial was stopped prematurely. In total, 19 women were

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2018 PLoS ONE Controlled trial quality: predicted high

94. The influence of timing of Maternal administration of Antibiotics during cesarean section on the intestinal Microbial colonization in Infants (MAMI-trial): study protocol for a randomised controlled trial. (PubMed)

during pregnancy and delivery. Recent revisions to international obstetric guidelines have resulted in the exposure of all infants born by caesarean section (CS) to broad-spectrum antibiotics perinatally. To date, the consequences of these new guidelines on neonatal gut colonisation and the associated short- and long-term health implications have not yet been addressed. The aim of this study is to investigate the influence of the timing of antibiotic administration during CS to the mother (...) The influence of timing of Maternal administration of Antibiotics during cesarean section on the intestinal Microbial colonization in Infants (MAMI-trial): study protocol for a randomised controlled trial. A disturbance in the early colonisation of the gut by microorganisms is associated with an aberrant innate immune system and a variety of clinical conditions later in life. Several factors are considered to influence this initial colonisation, including maternally administered antibiotics

2019 Trials Controlled trial quality: uncertain

95. The Effect of Non-penicillin Antibiotic Regimens on Neonatal Outcomes in Preterm Premature Rupture of Membranes. (PubMed)

The Effect of Non-penicillin Antibiotic Regimens on Neonatal Outcomes in Preterm Premature Rupture of Membranes. Objective  A 7-day course of a penicillin (PCN) and macrolide is standard of care (SAR) in preterm premature rupture of membranes (PPROM). Data regarding alternative antibiotic regimens are limited. We sought to assess the impact of non-PCN regimens on neonatal outcomes. Study Design  Secondary analysis of randomized controlled trial of antenatal magnesium sulfate. Singleton (...) , nonanomalous pregnancies complicated by PPROM at > 24 weeks of gestation receiving the SAR were compared with women receiving a non- β -lactam regimen and a macrolide (NPCR). Primary outcome was a neonatal composite. Secondary outcomes included pregnancy latency, endometritis, and chorioamnionitis. Results  A total of 949 women met inclusion criteria; 821(56%) received the SAR and 128(8.8%) received NPCR. Adjusted models did not demonstrate worse outcomes (AOR [adjusted odds ratio] = 0.50; 95% CI

2019 AJP Reports Controlled trial quality: predicted high

96. Impact of Azithromycin-Based Extended-Spectrum Antibiotic Prophylaxis on Noninfectious Cesarean Wound Complications. (PubMed)

. This is a secondary analysis of the C/SOAP (Cesarean Section Optimal Antibiotic Prophylaxis) randomized controlled trial, which enrolled women with singleton pregnancies ≥24 weeks who were undergoing nonelective cesarean. Women were randomized to adjunctive azithromycin or identical placebo up to 1 hour preincision. All wound complications occurring within 6 weeks were adjudicated into infection and noninfectious wound complications (seroma, hematoma, local cellulitis, and other noninfectious wound breakdown (...) Impact of Azithromycin-Based Extended-Spectrum Antibiotic Prophylaxis on Noninfectious Cesarean Wound Complications.  Adding azithromycin to standard antibiotic prophylaxis for unscheduled cesarean delivery has been shown to reduce postcesarean infections. Because wound infection with ureaplasmas may not be overtly purulent, we assessed the hypothesis that azithromycin-based extended-spectrum antibiotic prophylaxis also reduces wound complications that are identified as noninfectious

2019 American journal of perinatology Controlled trial quality: predicted high

97. Effects of antibiotics use during pregnancy on risk of spontaneous abortion: a systematic review and meta-analysis

Effects of antibiotics use during pregnancy on risk of spontaneous abortion: a systematic review and meta-analysis 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

98. A Review of Antibiotic Use in Pregnancy. (PubMed)

A Review of Antibiotic Use in Pregnancy. During pregnancy, untreated sexually transmitted or urinary tract infections are associated with significant morbidity, including low birth weight, preterm birth, and spontaneous abortion. Approximately one in four women will be prescribed an antibiotic during pregnancy, accounting for nearly 80% of prescription medications in pregnant women. Antibiotic exposures during pregnancy have been associated with both short-term (e.g., congenital abnormalities (...) ) and long-term effects (e.g., changes in gut microbiome, asthma, atopic dermatitis) in the newborn. However, it is estimated that only 10% of medications have sufficient data related to safe and effective use in pregnancy. Antibiotics such as beta-lactams, vancomycin, nitrofurantoin, metronidazole, clindamycin, and fosfomycin are generally considered safe and effective in pregnancy. Fluoroquinolones and tetracyclines are generally avoided in pregnancy. Physiologic changes in pregnancy lead

2015 Pharmacotherapy

99. 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 (31 July 2014) 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 seven randomised controlled trials. Approximately 2100 women were recruited to detect the effect of prophylactic antibiotic

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2015 Cochrane database of systematic reviews (Online)

100. Genital carriage of the genus Haemophilus in pregnancy: species distribution and antibiotic susceptibility. (PubMed)

Genital carriage of the genus Haemophilus in pregnancy: species distribution and antibiotic susceptibility. Recent reports have hypothesized that colonization of the maternal genital tract with non-capsulated Haemophilus influenzae could result in neonatal invasive disease. In this study, genital carriage of the genus Haemophilus was investigated in 510 pregnant women attending an Italian hospital for routine controls. Overall, vaginal carriage of the genus Haemophilus was 9.0 % (46/510 (...) ). A high colonization rate with Haemophilus parainfluenzae (37/510, 7.3 %) was found; other species, such as Haemophilus pittmaniae (7/510, 1.4 %) and Haemophilus haemolyticus (2/510, 0.4 %), were detected for the first time in the genital flora by 16S rRNA gene sequencing. Notably, no H. influenzae was identified, in agreement with previous investigations indicating that this species is rarely isolated from the genito-urinary tract of pregnant women. No antibiotic resistance was detected in H

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2015 Journal of Medical Microbiology

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