Recently published research suggests that significant progress has been made in reducing antibiotic use without indication during vaginal delivery hospitalizations. The study, which appeared in Obstetrics & Gynecology, analyzed hospitalizations for more than 5 million deliveries.
Although appropriate antibiotic use may result in significant maternal and neonatal benefits, inappropriate use could result in unnecessary maternal and neonatal risk and could contribute to antibiotic overuse. The purpose of the study was to evaluate antibiotic trends during delivery hospitalizations in the United States.
The data used were from the Premier Perspective database, an administrative inpatient database that reports on 100% of hospitalizations for 600 individual hospitals and ambulatory surgery centers across the United States. For the analysis, all women between aged 18 to 54 years who underwent a delivery hospitalization from January 2006 through March 2015 were included. The Perspective Database was also queried for antibiotics that are commonly used during delivery hospitalizations, including generics.
The authors identified delivery hospitalizations based on ICD-9-CM billing codes. Evidence-based indications for antibiotic administration during vaginal deliveries included: 1) preterm prelabor rupture of membranes (PPROM); 2) endometritis; 3) chorioamnionitis; 4) group B Streptococcus (GBS) colonization; and 5) other infectious complications (i.e. urinary tract infection [UTI], pneumonia, and sepsis). The authors also evaluated temporal trends in antibiotic administration for all cesarean deliveries and vaginal deliveries with an evidence-based indication for antibiotic administration.