Published: 2019-01-24

Prescription pattern of antimicrobials in pregnant women attending antenatal clinic in a tertiary care hospital in Telangana, India

Md. Amirunnisa Begum, B. Krishna Sowmya, D. Shailendra


Background: Pregnancy is a physiological condition during which immune system is weakened. Therefore, most women are prone to develop infections during this period for which antimicrobials are prescribed. Drugs used during pregnancy may lead to teratogenicity. Therefore, this study was done with the following objectives: determine the type of infections encountered, assess the prescription profile of antimicrobials and assess FDA categories of antimicrobials used in pregnant women in a tertiary care center in Telangana, India.

Methods: This was a prospective observational study conducted on pregnant women attending antenatal clinic (ANC) at Mediciti Institute of Medical Sciences (MIMS) from 1st January 2018 to 30th June 2018.

Results: Out of a total of 165 cases enrolled, 57 (34.5%) cases were prescribed antimicrobials and 108 (65.5%) were treated symptomatically. The mean (SD) age of women who were prescribed antimicrobials was 22.9 (2.97) years. Of the conditions encountered, respiratory tract infections (RTIs) accounted for 31%, followed by urinary tract infections (UTIs) 26% and gastroenteritis 25%. Most prevalent infections which required antimicrobials prescription were UTIs (36.84%), followed by Gastroenteritis (17.54%). Majority of the antimicrobials prescribed were from Betalactams (40.34%), followed by Nitrofuranes (29.82%), Nitroimidazoles (17.54%) and Antifungals (8.77%). Antimicrobials prescription was more in the 3rd trimester (63.1%), followed by 2nd trimester (31.6%) and 1st trimester (5.3%). Majority of the antimicrobials were administered orally (75.44%), followed by injections (15.79%) and per vaginal route (8.77%). Antimicrobials were mostly prescribed from FDA Category B (96%).

Conclusions: RTIs were the most common among the conditions encountered. However, UTIs were the leading cause for antimicrobial prescriptions. Antimicrobials prescription was more during 3rd trimester. Most antimicrobials prescribed were safe as they were from FDA Category B.


Antimicrobials, FDA category, Infections, Pregnancy

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Eze UI, Eferakeya AE, Oparah AC, Enato EF. Assessment of prescription profile of pregnant women visiting antenatal clinics. Pharmacy Practice (Internet). 2007 Sep;5(3):135-9.

Heikkilä AM. Antibiotics in Pregnancy A Prospective Cohort Study on the Policy of Antibiotic Prescription. Annals of Medicine. 1993 Jan 1;25(5):467-71.

Bookstaver PB, Bland CM, Griffin B, Stover KR, Eiland LS, McLaughlin M. A review of antibiotic use in pregnancy. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy. 2015 Nov;35(11):1052-62.

Nahum GG, Uhl K, Kennedy DL. Antibiotic use in pregnancy and lactation: what is and is not known about teratogenic and toxic risks. Obste Gynecol. 2006 May 1;107(5):1120-38.

Andrade SE, Gurwitz JH, Davis RL, Chan KA, Finkelstein JA, Fortman K, et al. Prescription drug use in pregnancy. Am J Obstet Gynecol. 2004;191:398-407.

de Tejada BM. Antibiotic Use and Misuse during Pregnancy and Delivery: Benefits and Risks; Int J Environ Res Public Health. 2014 Aug;11(8):993-8009.

Costantine MM. Physiologic and pharmacokinetic changes in pregnancy. Front Pharmacol. 2014;65:1-5.

Young VS. Teratogenicity and Drugs in the breast milk. Applied Therapeutics: The Clinical Use of Drugs 7th edition USA Lippincott Williams & Wilkins; 2001.

Collabourative Group on Drug Use in Pregnancy. An international survey on drug utilization. Int J Risk Safety Med. 1991;1:1.

Babu RH, Basha KM, Kumar BS, Nagaraju R. A Study on Anti-microbial Prescribing Pattern during Pregnancy in a Tertiary care Hospital in South India. Int J Innov Pharma Res. 2010;1(1):11-3.

Mensah KB, Opoku-Agyeman K, Ansah C. Antibiotic use during pregnancy: a retrospective study of prescription patterns and birth outcomes at an antenatal clinic in rural Ghana. J Pharma Poli Practi. 2017 Dec;10(1):24.

Masinde A, Gumodoka B, Kilonzo A, Mshana SE. Prevalence of urinary tract infection among pregnant women at Bugando medical Centre, Mwanza,Tanzania. Tanzan J Health Res. 2009;11(3).

Köksal Ö, Özdemir F, Armağan E, Öner N, Sert PÇ, Sigirli D. Is routine pregnancy test necessary in women of reproductive age admitted to the emergency department World J Emerg Med. 2013;4(3):175.

Das B, Sarkar C, Datta A, Bohra S. A study of drug use during pregnancy in a Teaching Hospital in Western Nepal. Pharmacoepidemiol Drug Saf. 2003;12(3):221-5.

Mensah KB, Ansah C. Irrational use of antibiotics and the risk of diabetes in Ghana. Ghana Med J. 2016;50(2):107-14.

Prescott SL, Clifton V. Asthma and pregnancy: emerging evidence of epigenetic interactions in utero. Curr Opin Allergy Clin Immunol. 2009;1:9(5):417-26.

Weber FH Jr, Richards RD, McCallum RW. Erythromycin: a motilin agonist and gastrointestinal prokinetic agent. Am J Gastroenterol. 1993;88(4):1.

Periti P, Mazzei T, Mini E, Novelli A. Adverse effects of macrolide antibacterials. Drug Saf. 1993;1:9(5):346-64.