Study reveals Regional Variations and Appropriate Use of Antibiotics During Pregnancy

Recent study examines antibiotic utilization during pregnancy across Italy, revealing significant frequency of prescriptions despite the limited clinical trial data concerning the safety and efficacy of these medications in this demographic. Conducted between April 2016 and March 2018, this multi-regional retrospective population-based study encompassed data from women aged 15 to 49 who gave birth in selected Italian regions, focusing on prescription patterns before, during, and after pregnancy.

Data Collection and Findings

Utilizing the Regional Certificate of Delivery Care (CeDAP) and regional drug prescription databases, the study collected sociodemographic and clinical details to analyze drug use. It determined that 31.8% of pregnant women received at least one antibiotic prescription, with variations noted across different trimesters. Pre-pregnancy, the prevalence was 33.9%, decreasing to 12.0% in the first trimester and peaking at 16.0% during the second trimester. Post-pregnancy use varied, with a notable rise to 15.3% in the first trimester after birth.

Antibiotic Classes and Usage Patterns

Penicillins emerged as the most prescribed antibiotic class, with increased usage during the second trimester aligned with prenatal diagnostics like amniocentesis and chorionic villus sampling (CVS). Other classes, including macrolides and lincosamides, followed in prevalence, though their usage decreased after pregnancy. Regional variations were significant, with Umbria and Lazio showing higher peaks during the second trimester related to invasive procedures, while Lombardy and Veneto exhibited lower antibiotic use in all periods assessed. The study highlights the implications of excessive antibiotic use during pregnancy, including potential contributions to antimicrobial resistance (AMR). Observations point to a correlation between higher antibiotic prescriptions and the timing of prenatal diagnostic tests, with over 60% of women undergoing amniocentesis receiving antibiotics during the second trimester, indicating a prevalent practice that may not align with national guidelines advocating against routine prophylactic antibiotic use.

Conclusions and Future Strategies

Conclusions drawn emphasize the necessity for renewed attention to antibiotic prescribing practices within prenatal care. The findings reveal inherent inconsistencies with national recommendations, potentially influenced by regional healthcare practices and clinician opinions. Future strategies could involve disseminating updated guidelines to mitigate unnecessary prescriptions and combat rising AMR rates. Overall, the study advocates for ongoing research into antibiotic utilization in pregnant populations to enhance understanding and formulate evidence-based practices.

Key Points

- The study analyzed antibiotic prescriptions among pregnant women in Italy from April 2016 to March 2018, finding that 31.8% of this population received at least one antibiotic prescription, despite limited clinical trial data on the safety and efficacy of such medications during pregnancy.

- Data showed a varying prevalence of antibiotic prescriptions across trimesters: 33.9% pre-pregnancy, which decreased to 12.0% in the first trimester, peaked at 16.0% during the second trimester, and increased again post-pregnancy to 15.3% in the first trimester after birth.

- Penicillins were identified as the most frequently prescribed class of antibiotics, with usage patterns influenced by prenatal diagnostic procedures. Other classes, such as macrolides and lincosamides, were less frequently prescribed and saw decreased use following pregnancy.

- Significant regional disparities in antibiotic use were noted, with higher prescription rates in regions like Umbria and Lazio during the second trimester, likely linked to invasive procedures, whereas Lombardy and Veneto displayed lower antibiotic prescriptions throughout all assessed periods.

- The findings highlighted a concerning trend where nearly 60% of women receiving amniocentesis were prescribed antibiotics during the second trimester, a practice that may contradict national guidelines against routine prophylactic antibiotic use.

- The study calls for enhanced scrutiny of antibiotic prescribing practices in prenatal care, suggesting the dissemination of updated guidelines to decrease unnecessary prescriptions and counter rising antimicrobial resistance (AMR) rates, alongside a need for further research on antibiotic use in pregnant populations.

Reference –

Michela Servadio et al. (2025). Real-World Antibiotic Utilization During Pregnancy In Italy: A Multiregional Retrospective Population-Based Study. *BMC Pregnancy And Childbirth*, 25. https://doi.org/10.1186/s12884-025-07605-0

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