title: Trends in anti-infective drugs use in pregnancy.
abstract: BACKGROUND
  Development of knowledge in understanding the use of anti-infective drugs during pregnancy has been limited by difficulties in testing medications in pregnant women and lack of evidence-based data. Overuse of broad spectra agents is associated with development and spread of bacterial resistance, a problem that is faced as a significant threat to the public health.
  
  
  OBJECTIVE
  To describe trends in use of general and broad spectrum anti-infective drugs during pregnancy.
  
  
  METHODS
  We used the Quebec Pregnancy Registry to analyse trends for use of oral anti-infectives dispensed during pregnancy for the five-year period comprised between January 1998 and December 2002. Trends in use were assessed for classes of anti-infectives and for broad-spectrum drugs. Descriptive statistics were used to summarize the characteristics of the study population. Annual trends for the use of anti-infective drugs were analyzed using the Cochran-Armitage test.
  
  
  RESULTS
  The use of anti-infective drugs and broad spectrum agents during pregnancy decreased from 1998 to 2002 (p ≤ 0.05 for trends). The classes that showed increasing trend for use were: macrolides, quinolones, tetracyclines, urinary anti-infective drugs and antimycotics. Use of penicillins and sulfonamides decreased. Azithromycin showed a remarkable increase in its use: 0.04% of all anti-infective prescriptions in 1998, compared to 10.16% in 2002.
  
  
  CONCLUSIONS
  Decrease in the use of broad-spectrum drugs may have been caused by a positive impact of data issued from evidence in everyday life clinical practice. More data is needed to evaluate the impact of the knowledge transfer from evidence-based studies on prescription's trends during pregnancy.
authors.affiliation: Faculty of Pharmacy, University of Montreal, Montreal, Quebec, Canada.
authors.forename: Fabiano
authors.initials: F
authors.lastname: Santos
authors.forename: Odile
authors.initials: O
authors.lastname: Sheehy
authors.forename: Sylvie
authors.initials: S
authors.lastname: Perreault
authors.forename: Ema
authors.initials: E
authors.lastname: Ferreira
authors.forename: Anick
authors.initials: A
authors.lastname: Bérard
mesh_terms: D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data / Q000639:trends*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy; D011792:Quebec; D012042:Registries
chemical_list: D000890:Anti-Infective Agents