การใช้ยาปฏิชีวนะเพื่อป้องกันการติดเชื้อในหญิงคลอดปกติครบกำหนด ทางช่องคลอด ณ โรงพยาบาลมหาราชนครเชียงใหม่  จังหวัดเชียงใหม่

Kritsadathan T; Phithakham C; Piyamongkol W

Authors

Kritsadathan T Division of Pharmacy, Maharaj Nakorn Chiang Mai Hospital, Thailand https://orcid.org/0000-0001-8460-6074
Phithakham C Division of Pharmacy, Maharaj Nakorn Chiang Mai Hospital, Thailand
Piyamongkol W Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Thailand

Keywords:

antibiotics prophylaxis, vaginal delivery, RDU hospital

Abstract

Objective To identify the percentage of antibiotic prophylaxis use in full-term vaginal
deliveries, documenting type, characteristics (dosage and route of administration) and reasons for the use of antibiotics. This study also compared the percentage of wound infection or puerperal sepsis in two groups of patient’s receiving antibiotic prophylaxis and patients who not receiving antibiotic prophylaxis.

Methods The study design was a retrospective cohort study. Researchers reviewed medical records of patients who admitted to Maharaj Nakorn Chiang Mai Hospital during labouring in 2016. Data was collected on the degree of episiotomy tear, receipt of antibiotics, reasons for the use of antibiotics, type, characteristics and infection outcome at follow up (42 days).

Results Out of 502 women who had normal term labour, 114 received antibiotics (22.71%). Of women receiving antibiotics, almost half (47 of 114) were prescribed antibiotics to prevent post-labour infection. Within this group 72.34% (34 of 47) were prescribed antibiotics inappropriately. In the inappropriate use group, antibiotic use included fecal contamination (24 patients, 51.06%), deep wound or prolonged-surgical procedure (6 patients, 12.77%) and anemia (4 patients, 8.51%). However, in the group that did not receive antibiotics, one patient with a third- and fourth-degree tear should have received antibiotic prophylaxis. Of all patients receiving antibiotics, the type and characteristics were inappropriate given that all patients received oral antibiotics rather than injection. There was no significant difference in rates of wound infection or puerperal sepsis at 42 days after delivery between patients receiving antibiotic prophylaxis and those who did not

Conclusion The percentage of antibiotic prophylaxis use in full-term vaginal delivery is higher than rational drug use hospital’ criteria. Type, characteristics and reasons for the use of antibiotics were inappropriate. Finally, the incidence of infection was not significantly different between groups that did and did not receive antibiotics.

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