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Article

Antibiotic Prescriptions among China Ambulatory Care Visits of Pregnant Women: A Nationwide Cross-Sectional Study

by 1, 2, 2,*,† and 1,3,4,*,†
1
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
2
Department of Pharmacology, The 7th Medical Center of Chinese PLA General Hospital, Beijing 100700, China
3
Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing 100191, China
4
Center for Intelligent Public Health, Institute for Artificial Intelligence, Peking University, Beijing 100871, China
*
Authors to whom correspondence should be addressed.
These authors contributed equally to this work.
Academic Editor: Akke Vellinga
Received: 27 April 2021 / Revised: 13 May 2021 / Accepted: 13 May 2021 / Published: 19 May 2021
(This article belongs to the Special Issue Appropriateness of Antibiotics in China)
Background: Antibiotic use in pregnant women at the national level has rarely been reported in China. Objectives: We aimed to investigate antibiotic prescriptions during pregnancy in ambulatory care settings in China. Methods: Data of 4,574,961 ambulatory care visits of pregnant women from October 2014 to April 2018 were analyzed. Percentages of Antibiotic prescriptions by different subgroups and various diagnosis categories and proportions of inappropriate antibiotic prescriptions for different subgroups were estimated. Food and Drug Administration (FDA) pregnancy categories were used to describe the antibiotic prescription patterns. The 95% confidence intervals (CIs) were estimated using the Clopper––Pearson method or Goodman method. Results: Among the 4,574,961 outpatient visits during pregnancy, 2.0% (92,514 visits; 95% CI, 2.0–2.0%) were prescribed at least one antibiotic. The percentage of antibiotic prescriptions for pregnant women aged >40 years was 4.9% (95% CI, 4.7–5.0%), whereas that for pregnant women aged 26–30 years was 1.5% (95% CI, 1.4–1.5%). In addition, percentages of antibiotic prescriptions varied among different trimesters of pregnancy, which were 5.4% (95% CI, 5.3–5.4%) for the visits in the first trimester of pregnancy and 0.5% (95% CI, 0.4–0.5%) in the third trimester of pregnancy. Furthermore, the percentages of antibiotic prescriptions substantially varied among different diagnosis categories and nearly three-quarters of antibiotic prescriptions had no clear indications and thus might be inappropriate. In total, 130,308 individual antibiotics were prescribed; among these, 60.4% (95% CI, 60.0–60.8%) belonged to FDA category B, 2.7% (95% CI, 2.1–3.5%) were classified as FDA category D and 16.8% (95% CI, 16.2–17.4%) were not assigned any FDA pregnancy category. Conclusions: Antibiotic prescriptions in ambulatory care during pregnancy were not highly prevalent in mainland China. However, a substantial proportion of antibiotics might have been prescribed without adequate indications. Antibiotics whose fetal safety has not been sufficiently illustrated were widely used in pregnant women. View Full-Text
Keywords: antibiotics; pregnancy; outpatients antibiotics; pregnancy; outpatients
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MDPI and ACS Style

Zhao, H.; Zhang, M.; Bian, J.; Zhan, S. Antibiotic Prescriptions among China Ambulatory Care Visits of Pregnant Women: A Nationwide Cross-Sectional Study. Antibiotics 2021, 10, 601. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics10050601

AMA Style

Zhao H, Zhang M, Bian J, Zhan S. Antibiotic Prescriptions among China Ambulatory Care Visits of Pregnant Women: A Nationwide Cross-Sectional Study. Antibiotics. 2021; 10(5):601. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics10050601

Chicago/Turabian Style

Zhao, Houyu, Mei Zhang, Jiaming Bian, and Siyan Zhan. 2021. "Antibiotic Prescriptions among China Ambulatory Care Visits of Pregnant Women: A Nationwide Cross-Sectional Study" Antibiotics 10, no. 5: 601. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics10050601

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