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Intrapartum and postpartum antibiotic use in seven low- and middle-income countries: Findings from the A-PLUS trial.
Saleem, Sarah; Yasmin, Haleema; Moore, Janet L; Rahim, Anum; Shakeel, Iram; Lokangaka, Adrien; Tshefu, Antoinette; Bauserman, Melissa; Mwenechanya, Musaku; Chomba, Elwyn; Goudar, Shivaprasad S; Kavi, Avinash; Derman, Richard J; Krebs, Nancy F; Figueroa, Lester; Mazariegos, Manolo; Nyongesa, Paul; Bucher, Sherri; Esamai, Fabian; Patel, Archana; Waikar, Manjushree; Shivkumar, Poonam; Hibberd, Patricia L; Petri, William A; Billah, Sk Masum; Haque, Rashidul; Carlo, Waldemar A; Tita, Alan; Koso-Thomas, Marion; Hemingway-Foday, Jennifer; McClure, Elizabeth M; Goldenberg, Robert L.
Afiliação
  • Saleem S; Aga Khan University, Karachi, Pakistan.
  • Yasmin H; Jinnah Postgraduate Medical Centre, Karachi, Pakistan.
  • Moore JL; RTI International, Durham, North Carolina, USA.
  • Rahim A; Aga Khan University, Karachi, Pakistan.
  • Shakeel I; Aga Khan University, Karachi, Pakistan.
  • Lokangaka A; Kinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo.
  • Tshefu A; Kinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo.
  • Bauserman M; University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
  • Mwenechanya M; University of Zambia University Teaching Hospital, Lusaka, Zambia.
  • Chomba E; University of Zambia University Teaching Hospital, Lusaka, Zambia.
  • Goudar SS; KLE Academy Higher Education and Research, J N Medical College Belagavi, Belagavi, Karnataka, India.
  • Kavi A; KLE Academy Higher Education and Research, J N Medical College Belagavi, Belagavi, Karnataka, India.
  • Derman RJ; Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
  • Krebs NF; University of Colorado School of Medicine, Denver, Colorado, USA.
  • Figueroa L; Instituto de Nutrición de Centroamérica y Panamá, Guatemala City, Guatemala.
  • Mazariegos M; Instituto de Nutrición de Centroamérica y Panamá, Guatemala City, Guatemala.
  • Nyongesa P; Moi University School of Medicine, Eldoret, Kenya.
  • Bucher S; Indiana School of Medicine, University of Indiana, Indianapolis, Indiana, USA.
  • Esamai F; Moi University School of Medicine, Eldoret, Kenya.
  • Patel A; Lata Medical Research Foundation, Nagpur, India.
  • Waikar M; Datta Meghe Institute of Higher Education and Research, Sawangi, India.
  • Shivkumar P; Government Medical College, Nagpur, India.
  • Hibberd PL; Mahatma Gandhi Institute of Medical Sciences, Wardha, India.
  • Petri WA; Boston University School of Public Health, Boston, Massachusetts, USA.
  • Billah SM; University of Virginia, Charlottesville, Virginia, USA.
  • Haque R; International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh.
  • Carlo WA; University of Sydney, Sydney, New South Wales, Australia.
  • Tita A; International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh.
  • Koso-Thomas M; University of Alabama at Birmingham, Birmingham, Alabama, USA.
  • Hemingway-Foday J; University of Alabama at Birmingham, Birmingham, Alabama, USA.
  • McClure EM; Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA.
  • Goldenberg RL; RTI International, Durham, North Carolina, USA.
BJOG ; 2024 Aug 14.
Article em En | MEDLINE | ID: mdl-39140197
ABSTRACT

OBJECTIVE:

To describe the intrapartum and postpartum use of non-study antibiotics in low- and middle-income countries (LMICs) during the double-blinded NICHD Global Network Azithromycin in Labor (A-PLUS) trial.

DESIGN:

The antibiotic use sub-study was a planned prospective, observational sub-study of the A-PLUS trial. SETTINGS The study was carried out in hospitals or health centres affiliated with eight sites of the Global Network for Women's and Children's Health Research (Global Network) in seven countries Bangladesh, Pakistan, India (two sites), Kenya, Zambia, The Democratic Republic of the Congo (DRC) and Guatemala. POPULATION Totally, 29 278 pregnant women enrolled in the A-PLUS trial.

METHODS:

We collected data on 29 278 pregnant women admitted to a facility for delivery related to non-study antibiotic use overall and during three time periods (1) in the facility prior to delivery, (2) after delivery until facility discharge and (3) after discharge to 42 days post-partum. MAIN OUTCOME

MEASURES:

Non-study antibiotic use overall and for treatment or prophylaxis by the site during the three time periods.

RESULTS:

Of the 29 278 women in the study, 5020 (17.1%; 95% CI 16.7%-17.6%) received non-study antibiotics in the facility prior to delivery, 11 956 (40.8%; 95% CI 40.3%-41.4%) received non-study antibiotics in the facility after delivery, and 13 390 (47.6%; 95% CI 47.0%-48.2%) women received non-study antibiotics after delivery and after facility discharge. Antibiotics were prescribed more often among women in the Asian and Guatemalan sites than in the African sites. In the three time-periods, among those receiving antibiotics, prophylaxis was the indication in 82.3%, 97.7% and 90.7% of the cases, respectively. The type of antibiotics used varied substantially by time-period and site, but generally, penicillin-type drugs, cephalosporin-type drugs and metronidazole were used more frequently than other types.

CONCLUSIONS:

Across the eight sites of the Global Network, in the facility before delivery, and in the post-partum periods before and after facility discharge, antibiotics were used frequently, but use was highly variable by site and time-period.
Palavras-chave

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: BJOG Assunto da revista: GINECOLOGIA / OBSTETRICIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Paquistão País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: BJOG Assunto da revista: GINECOLOGIA / OBSTETRICIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Paquistão País de publicação: Reino Unido