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Antibiotics in pregnancy: analysis of potential risks and determinants in a large German statutory sickness fund population
Author(s) -
Amann Ute,
EgenLappe Veronika,
StrunzLehner Christine,
Hasford Joerg
Publication year - 2006
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/pds.1225
Subject(s) - medicine , antibiotics , pregnancy , medical prescription , logistic regression , pharmacoepidemiology , population , intensive care medicine , environmental health , obstetrics , pediatrics , pharmacology , genetics , microbiology and biotechnology , biology
Purpose Antibiotics are frequently prescribed drugs in pregnancy. The purpose of the study was to analyse the use, the potential risks and the determinants of systemic antibiotic prescriptions during pregnancy. Methods A large, nation‐wide acting German statutory sickness fund provided prescription data and personal data of 41 293 pregnant women. For this study, all prescriptions of systemic antibiotics (ATC: J01) dispensed to each woman during a 21‐month period were analysed. We used the FDA risk classification system and enrolled a literature search to identify potentially harmful antibiotics. To investigate the impact of geographical and socio‐economic determinants in antibiotic prescribing, a multivariate logistic regression model was performed. Results Of the 41 293 women, 19.7% received at least one antibiotic drug during pregnancy. There was a shift to relatively safe and reduced antibiotic drug use during pregnancy. Prescribing of contraindicated antibactericals or potentially harmful drugs was seen in 521 women (1.3% of all women). In the logistic regression, being younger than 21 years (adjusted OR 2.14, 95%CI 1.80–2.53) or being welfare recipient (adjusted OR 1.57, CI 1.25–2.00) was strongly associated with higher antibiotic use. Significantly lower antibiotic use was seen in 5 of 16 German federal states (OR 0.74–0.83). Conclusions About 20% of pregnant women received antibiotics, and 1.3% received a harmful drug. To minimise the risks, detailed guidelines are needed for the antibiotic treatment during pregnancy. Copyright © 2006 John Wiley & Sons, Ltd.