Antibiotic use and preterm labor: attitudes and practice patterns of North Carolina obstetric providers.
BACKGROUND
Despite the reported link between subclinical genital tract infection (GTI) and preterm labor (PTL), it is not certain that treating PTL empirically with antibiotics decreases neonatal morbidity and mortality. This study describes the beliefs of family physicians and nurse-midwives regarding the link between subclinical GTI and PTL and their use of empiric antibiotics to treat spontaneous PTL.


METHODS
This was a survey of family physicians, family practice residents, and midwives (n = 588) who practice obstetrics in North Carolina. The response rate was 61%.


RESULTS
Ninety-six percent of providers search for GTI, and 76% believe antibiotics for presumed infection will benefit the neonate. Wide variation in the use of antibiotics exists within groups and between groups of providers. Nurse-midwives are more likely than family physicians to use broad-spectrum antibiotics (p < 0.001).


CONCLUSIONS
Family physicians and nurse-midwives are uncertain about the optimal management of PTL. Empiric antibiotic use varies widely despite the lack of supportive data.
Andy
Camille
C
Department of Family Medicine, University of North Carolina, Moses Cone Family Practice Residency Program, 1125 North Church Street, Greensboro, NC 27401, USA. camille.andy@mosescone.com
D000328:Adult; D000900:Anti-Bacterial Agents / Q000145:classification / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D008875:Middle Aged; D008880:Midwifery; D009657:North Carolina / Q000453:epidemiology; D007752:Obstetric Labor, Premature / Q000150:complications / Q000188:drug therapy*; D010821:Physicians, Family; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000188:drug therapy*; D011795:Surveys and Questionnaires; D016585:Vaginosis, Bacterial / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*
D000900:Anti-Bacterial Agents