Details:

Alternative Title:
MMWR Morb Mortal Wkly Rep
Publisher's site:
http://dx.doi.org/10.15585/mmwr.mm6701a4
Personal Author:
Ailes, Elizabeth C. ; Summers, April D. ; Tran, Emmy L. ; Gilboa, Suzanne M. ; Arnold, Kathryn E. ; ... More +
Ailes, Elizabeth C. ; Summers, April D. ; Tran, Emmy L. ; Gilboa, Suzanne M. ; Arnold, Kathryn E. ; Meaney-Delman, Dana ; Reefhuis, Jennita Less -
Description:
Urinary tract infections (UTIs) occur in about 8% of pregnant women, and untreated UTIs can have serious consequences, including pyelonephritis, preterm labor, low birth weight, and sepsis (1). Pregnant women are typically screened for UTIs during early pregnancy, and those with bacteriuria are treated with antibiotics (1,2). Antibiotic stewardship is critical to improving patient safety and to combating antibiotic resistance. Because of the potential risk for birth defects, including anencephaly, heart defects, and orofacial clefts, associated with use of sulfonamides and nitrofurantoin during pregnancy (3), a 2011 committee opinion from the American College of Obstetricians and Gynecologists (ACOG) recommended that sulfonamides and nitrofurantoin may be prescribed in the first trimester of pregnancy only when other antimicrobial therapies are deemed clinically inappropriate (4). To assess the effects of these recommendations, CDC analyzed the Truven Health MarketScan Commercial Database* to examine antibiotic prescriptions filled by pregnant women with UTIs. Among 482,917 pregnancies in 2014, 7.2% of women had an outpatient UTI diagnosis during the 90 days before the date of last menstrual period (LMP) or during pregnancy. Among pregnant women with UTIs, the most frequently prescribed antibiotics during the first trimester were nitrofurantoin, ciprofloxacin, cephalexin, and trimethoprim-sulfamethoxazole. Given the potential risks associated with use of some of these antibiotics in early pregnancy and the potential for unrecognized pregnancy, women's health care providers should be familiar with the ACOG recommendations and consider the possibility of early pregnancy when treating women of reproductive age.
Subject:
[+]
Anti-Bacterial Agents
Drug Prescriptions
Female
Full Report
Humans
Insurance, Health
Practice Guidelines As Topic
Pregnancy
Pregnancy Trimester, First
Private Sector
Urinary Tract Infections

Source:
MMWR Morb Mortal Wkly Rep. 67(1):18-22.
Pubmed ID:
29324733
Pubmed Central ID:
PMC5769793
Document Type:
Journal Article
Place as Subject:
United States
Collection(s):
Morbidity and Mortality Weekly Report (MMWR)
Main Document Checksum:
[+]
urn:sha256:ad507bac0d1e41eca9eade82e469c0627d4c1056c5b35e93dfc632474fa552ee
File Type:

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