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Antibiotics in Pregnancy

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101. Early pregnancy loss

area, level of education and age ? compared with pregnant controls only Refer to online version, destroy printed copies after use Page 15 of 39 Queensland Clinical Guideline: Early pregnancy loss 4.2 Expectant management of ectopic pregnancy Expectant management is an option for selected women. Clear criteria for selection have not been well defined. 26 Table 10. Expectant management of ectopic pregnancy Aspect Consideration Context • Among selected cases (early gestation, with ß-hCG values below (...) 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

2017 Queensland Health

102. Management of Pregnancy in Patients With Complex Congenital Heart Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association Full Text available with Trip Pro

and carry a pregnancy to term will present little problem. However, for those with complex CHD, pregnancy may be associated with an increased risk compared with women with milder forms of CHD, regardless of whether they are clinically stable at the time of conception. This document provides an overview of the management of the patient with complex CHD who becomes pregnant. Defining the Population Simple CHD lesions include mild pulmonary valve stenosis, a small, uncomplicated atrial septal defect (...) changes in blood volume. Reprinted with permission from Longo et al. Copyright © 1983, American Physiological Society. B-Type Natriuretic Peptide The median level of B-type natriuretic peptide (BNP) in normal pregnant woman is about twice that of nonpregnant control subjects, rising early in pregnancy and remaining high throughout gestation until ≈72 hours after delivery. , Adverse maternal cardiac events have been associated with high BNP concentrations (>100 pg/mL), but its use as a negative

2017 American Heart Association

103. Guidelines for the Use of Laparoscopy during Pregnancy

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 (...) ultrasound, CT, and/or MRI. A risk-benefit discussion with the patient should occur prior to any diagnostic study. Ultrasound Guideline 1: Ultrasound imaging during pregnancy is safe and effective in identifying the etiology of acute abdominal pain in many patients and should be the initial imaging test of choice (+++; Strong). Abdominal pain in the pregnant patient can be separated into gynecologic and non-gynecologic causes. When radiographic studies are required to establish a diagnosis, ultrasound

2017 Society of American Gastrointestinal and Endoscopic Surgeons

104. Antibiotic use during pregnancy: how bad is it? Full Text available with Trip Pro

Antibiotic use during pregnancy: how bad is it? Our microbial companions (the "microbiota") are extremely important for the preservation of human health. Although changes in bacterial communities (dysbiosis) are commonly associated with disease, such changes have also been described in healthy pregnancies, where the microbiome plays an essential role in maternal and child health outcomes, including normal immune and metabolic function in later life. Nevertheless, this new understanding (...) of the importance of the microbiome has not yet influenced contemporary clinical practice regarding antibiotic use during pregnancy.Antibiotic treatment during pregnancy is widespread in Western countries, and accounts for 80 % of prescribed medications in pregnancy. However, antibiotic treatment, while at times lifesaving, can also have detrimental consequences. A single course of antibiotics perturbs bacterial communities, with evidence that the microbial ecosystem does not return completely to baseline

2016 BMC Medicine

105. Control Cross Sectional Study Evaluating an Antibiotic Prevention Strategy in 30 Pregnancies Under Clean Intermittent Self-Catheterization and Review of Literature. (Abstract)

Control Cross Sectional Study Evaluating an Antibiotic Prevention Strategy in 30 Pregnancies Under Clean Intermittent Self-Catheterization and Review of Literature. To assess the efficacy and safety of a weekly oral cycling antibiotic (WOCA) strategy to prevent UTI in women.We performed a monocentric, comparative, retrospective, cross-sectional study on pregnant women under clean intermittent self catheterization between January 2008 and December 2014. WOCA consisted the administration (...) of a single-dose antibiotic, alternating antibiotic A and B once every 2 weeks, according to previous urine cultures.Twenty-five women carried out 30 pregnancies. Thirteen pregnancies (43.3%) were in the WOCA group (WCG) strategy and 17 were in the non-WOCA group (NWCG) (56.7%). In the 19 (63.3%) pregnancies with urinary tract infection (UTI), 5 (38.4%) were in WCG, 14 (82.3%) were not (P = .023). There were more cystitis in NWCG (76.5% vs 23.1% P = .009) but more colonization in WCG (46.2% vs 5.8% P

2016 Urology

106. Maternal Infections, Antibiotics and Paracetamol in Pregnancy and Offspring Celiac Disease: A Cohort Study. (Abstract)

Maternal Infections, Antibiotics and Paracetamol in Pregnancy and Offspring Celiac Disease: A Cohort Study. Infections in pregnancy are common, may affect fetal development, and have been linked to offspring autoimmunity. We aimed to determine whether maternal infections, the use of antibiotics, and use of paracetamol in pregnancy are associated with the risk of offspring celiac disease (CD).The nationwide Norwegian Mother and Child Cohort Study includes 84,274 children born in the period from (...) increased for categories 1 infection (1.01 [95% CI = 0.82-1.25]) and ≥2 infections (1.22 [95% CI = 1.00-1.49]) versus no infection. We found the same pattern for respiratory tract infections, but not for gastrointestinal infections. The aORs were broadly consistent across pregnancy periods of exposure. The use of antibiotics and paracetamol was, compared with no use, not associated with offspring CD (aOR = 1.16 [95% CI = 0.94-1.43] and aOR = 1.13 [95% CI = 0.96-1.33], respectively; P values for trend

2016 Journal of Pediatric Gastroenterology and Nutrition

107. Antibiotic use during pregnancy and asthma in preschool children: the influence of confounding. (Abstract)

Antibiotic use during pregnancy and asthma in preschool children: the influence of confounding. A recent study suggested that early-life intestinal microbiota may play an important role in the development of childhood asthma, indicating that antibiotics taken during early life or in late pregnancy may be associated with childhood asthma.This study aims to assess the association between prenatal antibiotic use and asthma in preschool children using data from the prescription database IADB.nl (...) regression was used to estimate crude and adjusted odds ratios (aORs).In both the case-sibling and case-control analysis, the use of antibiotics in the third trimester of pregnancy was associated with an increased risk of asthma in preschool children (aOR 1.37; 95% CI 1.02-1.83 and aOR 1.40; 95% CI 1.15-1.47). Time-trend analyses showed that results were not influenced by a time trend in antibiotic exposure. A significant association between exposure to antibiotics in any trimester of pregnancy

2016 Clinical and Experimental Allergy

108. Appendicitis during pregnancy in a Greenlandic Inuit woman; antibiotic treatment as a bridge-to-surgery in a remote area Full Text available with Trip Pro

Appendicitis during pregnancy in a Greenlandic Inuit woman; antibiotic treatment as a bridge-to-surgery in a remote area Appendicitis during pregnancy causes severe diagnostic problems, and is associated with an increase in perforation rate and morbidity compared to that in the normal population. In addition, it may cause preterm birth and fetal loss. In remote areas, appendicitis during pregnancy, besides presenting diagnostic problems, also creates treatment difficulties. In Northern (...) Greenland, geographical distances are vast, and weather conditions can be extreme. We report a case of a Greenlandic Inuit woman who presented with appendicitis during pregnancy. The nearest hospital with surgical and anaesthetic care was located nearly 1200 km away, and, due to extreme weather conditions, she could not be transferred immediately. She was treated with intravenous antibiotic treatment, and after weather conditions had improved, she was transferred by aeroplane and underwent

2016 BMJ case reports

109. Prophylactic Antibiotics in Twin Pregnancies Complicated by Previable Preterm Premature Rupture of Membranes Full Text available with Trip Pro

Prophylactic Antibiotics in Twin Pregnancies Complicated by Previable Preterm Premature Rupture of Membranes This study aims to determine if antibiotics given for latency to women with twins and previable preterm premature rupture of membranes (PPROM) affect the duration from membrane rupture to delivery.A retrospective cohort study of twin pregnancies at a single center from 2000 to 2015 with previable (14 (0/7)-22 (6/7) weeks) PPROM was conducted. Women who were not candidates for expectant (...) management or who elected for immediate delivery were excluded. Pregnancy complications, delivery data, and neonatal outcomes were compared between women who did and did not receive latency antibiotics. The primary outcome was latency.Of 52 eligible women, 30 (64%) elected expectant management; 17 women received antibiotics and 13 did not. No demographic differences existed between the groups. The median gestational age of rupture was 20 and 20.3 weeks in the antibiotic group and no antibiotic group

2016 AJP Reports

110. A New, Potent, and Placenta-Permeable Macrolide Antibiotic, Solithromycin, for the Prevention and Treatment of Bacterial Infections in Pregnancy Full Text available with Trip Pro

A New, Potent, and Placenta-Permeable Macrolide Antibiotic, Solithromycin, for the Prevention and Treatment of Bacterial Infections in Pregnancy Intrauterine infection-inflammation is a major cause of early preterm birth and subsequent neonatal mortality and acute or long-term morbidity. Antibiotics can be administered in pregnancy to prevent preterm birth either prophylactically to women at high risk for preterm delivery, or to women with diagnosed intrauterine infection, prelabor rupture (...) of membranes, or in suspected preterm labor. The therapeutic goals of each of these scenarios are different, with different pharmacological considerations, although effective antimicrobial therapy is an essential requirement. An ideal antibiotic for these clinical indications would be (a) one that is easily administered and orally bioactive, (b) has a favorable adverse effect profile (devoid of reproductive toxicity or teratogenicity), (c) is effective against the wide range of microorganisms known

2016 Frontiers in immunology

111. Virulence genes and antimicrobial susceptibility of lactose-negative and lactose-positive strains of Escherichia coli isolated from pregnant women and neonates Full Text available with Trip Pro

and the frequency of virulence genes (VGs). The study included 58 lac+ and 58 lac- E. coli strains isolated from pregnant women and neonates. Culture and the results of biochemical reactions were conducted for lac- and lac+ E. coli identification and differentiation. Disc diffusion test was performed to study the antimicrobial susceptibility of the isolates, and PCR was used to detect VGs. Resistance to at least one of the tested antibiotics was found among 14 (25.9%) E. coli lac+ and in 26 (44.9%) E. coli lac (...) Virulence genes and antimicrobial susceptibility of lactose-negative and lactose-positive strains of Escherichia coli isolated from pregnant women and neonates Escherichia coli can cause serious infections in the neonates and pregnant women. Although E. coli is widely studied, E. coli lactose-negative (lac-) strains have been rarely described before. So, the aim of this study was to compare lac- and lactose-positive (lac+) E. coli strains in respect of antimicrobial susceptibility

2017 Folia microbiologica

112. Serotype Distribution, Population Structure, and Antimicrobial Resistance of Group B Streptococcus Strains Recovered from Colonized Pregnant Women Full Text available with Trip Pro

Serotype Distribution, Population Structure, and Antimicrobial Resistance of Group B Streptococcus Strains Recovered from Colonized Pregnant Women Using serotyping, multilocus sequence typing, and whole-genome sequencing (WGS) of selected strains, we studied the population structure of 102 group B Streptococcus (GBS) isolates prospectively sampled in 2014 from vaginal/rectal swabs of healthy pregnant women in metropolitan Toronto, Canada. We also determined the susceptibilities of each (...) of the colonizing isolates to penicillin, erythromycin, clindamycin, tetracycline, and other antimicrobial agents. Overall, we observed a high rate of tetracycline resistance (89%) among colonizing GBS isolates. We found resistance to erythromycin in 36% of the strains, and 33% were constitutively or inducibly resistant to clindamycin. The most frequently identified serotypes were III (25%), Ia (23%), and V (19%). Serotype IV accounted for 6% of the colonizing isolates, a rate consistent with that observed

2017 Journal of clinical microbiology

113. Group B streptococcal screening, intrapartum antibiotic prophylaxis, and neonatal early-onset infection rates in an Australian local health district: 2006-2016. Full Text available with Trip Pro

Group B streptococcal screening, intrapartum antibiotic prophylaxis, and neonatal early-onset infection rates in an Australian local health district: 2006-2016. Intrapartum antibiotic prophylaxis (IAP) to reduce the likelihood of neonatal early-onset group B streptococcal infection (EOGBS) has coincided with major reductions in incidence. While the decline has been largely ascribed to IAP following either universal screening or a risk-based approach to identify mothers whose babies may most (...) regression and covariates for potential effect modifiers.Our cohort included 62,281 women who had 92,055 pregnancies resulting in 93,584 live born babies. Screening occurred in 76% of pregnancies; 69% had a result recorded, 21.5% of those were positive for GBS. Prophylaxis was used by 79% of this group. Eighteen babies developed EOGBS, estimated incidence/1000 live births in 2006 and 2016 was 0.35 (95% CI, 0.07 to 0.63) and 0.1 (95% CI, 0 to 0.2) respectively. Seven of 10 term babies with EOGBS were born

2019 PLoS ONE

114. A Review of Antibiotic Use in Pregnancy. (Abstract)

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

115. Impact of Intermittent Preventive Treatment in Pregnancy with Azithromycin-Containing Regimens on Maternal Nasopharyngeal Carriage and Antibiotic Sensitivity of Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus: a Cross-Sectional Full Text available with Trip Pro

Impact of Intermittent Preventive Treatment in Pregnancy with Azithromycin-Containing Regimens on Maternal Nasopharyngeal Carriage and Antibiotic Sensitivity of Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus: a Cross-Sectional Sulfadoxine-pyrimethamine (SP) plus azithromycin (AZ) (SPAZ) has the potential for intermittent preventive treatment of malaria in pregnancy (IPTp), but its use could increase circulation of antibiotic-resistant bacteria associated with severe (...) pediatric infections. We evaluated the effect of monthly SPAZ-IPTp compared to a single course of SP plus chloroquine (SPCQ) on maternal nasopharyngeal carriage and antibiotic susceptibility of Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus at delivery among 854 women participating in a randomized controlled trial in Papua New Guinea. Serotyping was performed, and antibiotic susceptibility was evaluated by disk diffusion and Etest. Potential risk factors for carriage were

2015 Journal of clinical microbiology Controlled trial quality: uncertain

116. Genital carriage of the genus Haemophilus in pregnancy: species distribution and antibiotic susceptibility. Full Text available with Trip Pro

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

2015 Journal of Medical Microbiology

117. Probiotics in pregnancy for infant atopic eczema

Probiotics in pregnancy for infant atopic eczema RACGP - Probiotics in pregnancy for infant atopic eczema Search Become a student member today for free and be part of the RACGP community A career in general practice Starting the GP journey Enrolments for the 2019.1 OSCE FRACGP exams closing 29 March 2019 Fellowship FRACGP exams Research Practice Experience Program is a self-directed education program designed to support non vocationally registered doctors on their pathway to RACGP Fellowship (...) Media Releases 2015 Media Releases 2014 Media Releases 2013 Media Releases 2012 Media Releases Search Probiotics in pregnancy for infant atopic eczema Probiotics in pregnancy for infant atopic eczema Introduction The gut of a healthy fetus is sterile. After delivery, the mother’s gut flora colonises the infant’s gut. Intervention Oral probiotics (containing only Lactobacillus species) taken by women during pregnancy and/or women and infants during the postpartum period. Indication Infants at higher

2016 Handbook of Non-Drug interventions (HANDI)

118. Probiotics in pregnancy for infant atopic eczema

Probiotics in pregnancy for infant atopic eczema RACGP - Probiotics in pregnancy for infant atopic eczema Search Become a student member today for free and be part of the RACGP community A career in general practice Starting the GP journey Enrolments for the 2019.1 OSCE FRACGP exams closing 29 March 2019 Fellowship FRACGP exams Research Practice Experience Program is a self-directed education program designed to support non vocationally registered doctors on their pathway to RACGP Fellowship (...) Media Releases 2015 Media Releases 2014 Media Releases 2013 Media Releases 2012 Media Releases Search Probiotics in pregnancy for infant atopic eczema Probiotics in pregnancy for infant atopic eczema Introduction The gut of a healthy fetus is sterile; after delivery the mother’s gut flora colonises the infant’s gut. Intervention Oral probiotics (containing only Lactobacillus species) taken by women during pregnancy and women and infants during the postpartum period. Indication Infants at higher risk

2016 Handbook of Non-Drug interventions (HANDI)

119. Antibiotics prior to amniotomy for reducing infectious morbidity in mother and infant. (Abstract)

Antibiotics prior to amniotomy for reducing infectious morbidity in mother and infant. Amniotomy (the deliberate rupture of membranes) was described almost two centuries ago and since then has been used both for induction and augmentation of labour - which are common obstetric practices. Trends have shown a rise in the induction rates over the last decade and data suggest that the rate of labour inductions is increasing faster than the rate of pregnancy complications. Recent years have seen (...) infectious morbidity.The objective of this review was to evaluate the prophylactic use of antibiotics versus placebo or no treatment prior to amniotomy on maternal and neonatal infectious morbidity and mortality.We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 August 2014), the International Clinical Trials Registry Platform (ICTRP) and ClinicalTrials.gov (12 September 2014).Randomised controlled trials or cluster-randomised trials comparing antibiotics prior to amniotomy

2014 Cochrane

120. Antibiotic prophylaxis for third- and fourth-degree perineal tear during vaginal birth. Full Text available with Trip Pro

infection. Prophylactic antibiotics might have a role in preventing this infection.To assess the effectiveness of antibiotic prophylaxis for reducing maternal morbidity and side effects in third- and fourth-degree perineal tear during vaginal birth.We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 August 2014) and the reference lists of retrieved articles.Randomised controlled trials comparing outcomes of prophylactic antibiotics versus placebo or no antibiotics in third (...) Antibiotic prophylaxis for third- and fourth-degree perineal tear during vaginal birth. One to eight per cent of women suffer third-degree perineal tear (anal sphincter injury) and fourth-degree perineal tear (rectal mucosa injury) during vaginal birth, and these tears are more common after forceps delivery (28%) and midline episiotomies. Third- and fourth-degree tears can become contaminated with bacteria from the rectum and this significantly increases in the chance of perineal wound

2014 Cochrane

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