Antibiotics prescribed before, during and after pregnancy in the Netherlands: a drug utilization study

PurposeTo describe the prescription of antibiotics before, during and after pregnancy, and the trends over a 16-year period in the Netherlands, and to determine whether they were prescribed according to national guidelines. MethodsThe IADB (http://iadb.nl) contains prescriptions dispensed by community pharmacies in the Netherlands. We extracted information on 18873 pregnancies for 14969 women between 1994 and 2009, focusing on antibiotics dispensed in the four trimesters before conception to two trimesters after birth (nine trimesters in total). We calculated trends in prescription rates during pregnancy and over time, and also compared the prescription of antibiotics in the Netherlands with safety category based on the Australian Drug Evaluation Committee. ResultsDuring pregnancy 20.8% of the women were prescribed at least one antibiotic. The beta-lactam antibacterials/penicillins' group and the specific antibiotic amoxicillin were most commonly prescribed in the nine trimesters covered. The prescription rate of the other antibacterials' group during pregnancy increased over the years, in contrast to that of the sulphonamides/trimethoprim' group, which decreased. In total, 2.0% of pregnancies were exposed to a potentially harmful' antibiotic and 0.8% to a harmful' antibiotic. Compared with the period before conception, safe' antibiotics were prescribed more often during pregnancy than the other groups. ConclusionsOne in five women was prescribed at least one antibiotic during pregnancy in the Netherlands, which is comparable with rates in other European countries. Our results suggest that antibiotics appear to be prescribed to pregnant women generally in accordance with national recommendations. Copyright (c) 2013 John Wiley & Sons, Ltd.