PubTransformer

A site to transform Pubmed publications into these bibliographic reference formats: ADS, BibTeX, EndNote, ISI used by the Web of Knowledge, RIS, MEDLINE, Microsoft's Word 2007 XML.

Antibiotics Dispensed to Privately Insured Pregnant Women with Urinary Tract Infections - United States, 2014.

Abstract 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.
PMID
Related Publications

National patterns in the treatment of urinary tract infections in women by ambulatory care physicians.

Antimicrobial resistance patterns in outpatient urinary tract infections--the constant need to revise prescribing habits.

National S3 guideline on uncomplicated urinary tract infection: recommendations for treatment and management of uncomplicated community-acquired bacterial urinary tract infections in adult patients.

Antibiotic failure in the treatment of urinary tract infections in young women.

Association between antibiotic use among pregnant women with urinary tract infections in the first trimester and birth defects, National Birth Defects Prevention Study 1997 to 2011.

Authors

Mayor MeshTerms

Private Sector

Keywords
Journal Title mmwr. morbidity and mortality weekly report
Publication Year Start




PMID- 29324733
OWN - NLM
STAT- MEDLINE
DCOM- 20180112
LR  - 20180112
IS  - 1545-861X (Electronic)
IS  - 0149-2195 (Linking)
VI  - 67
IP  - 1
DP  - 2018 Jan 12
TI  - Antibiotics Dispensed to Privately Insured Pregnant Women with Urinary Tract
      Infections - United States, 2014.
PG  - 18-22
LID - 10.15585/mmwr.mm6701a4 [doi]
AB  - 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.
FAU - Ailes, Elizabeth C
AU  - Ailes EC
FAU - Summers, April D
AU  - Summers AD
FAU - Tran, Emmy L
AU  - Tran EL
FAU - Gilboa, Suzanne M
AU  - Gilboa SM
FAU - Arnold, Kathryn E
AU  - Arnold KE
FAU - Meaney-Delman, Dana
AU  - Meaney-Delman D
FAU - Reefhuis, Jennita
AU  - Reefhuis J
LA  - eng
PT  - Journal Article
DEP - 20180112
PL  - United States
TA  - MMWR Morb Mortal Wkly Rep
JT  - MMWR. Morbidity and mortality weekly report
JID - 7802429
RN  - 0 (Anti-Bacterial Agents)
SB  - IM
MH  - Anti-Bacterial Agents/*therapeutic use
MH  - Drug Prescriptions/*statistics & numerical data
MH  - Female
MH  - Humans
MH  - Insurance, Health/*statistics & numerical data
MH  - Practice Guidelines as Topic
MH  - Pregnancy
MH  - Pregnancy Trimester, First
MH  - *Private Sector
MH  - United States
MH  - Urinary Tract Infections/*drug therapy
COIS- No conflicts of interest were reported.
EDAT- 2018/01/13 06:00
MHDA- 2018/01/13 06:01
CRDT- 2018/01/12 06:00
PHST- 2018/01/12 06:00 [entrez]
PHST- 2018/01/13 06:00 [pubmed]
PHST- 2018/01/13 06:01 [medline]
AID - 10.15585/mmwr.mm6701a4 [doi]
PST - epublish
SO  - MMWR Morb Mortal Wkly Rep. 2018 Jan 12;67(1):18-22. doi: 10.15585/mmwr.mm6701a4.