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Pharmacotherapy: Pharmacokinetics and Pharmacodynamics (including: ADE, TDM, DUE)
Treatment of urinary tract infections in pregnancy
  1. Lazarova B.,
  2. L. Mihailova,
  3. J. Bajraktar
  1. 1Hospital pharmacy, Clinical Hospital, Stip, FYROM
  2. 2Hospital pharmacy, Nephrology hospital, FYROM
  3. 3Hospital pharmacy, Clinical Hospital, Bitola, FYROM

Abstract

Background Urinary tract infections (UTIs) are one of the most common bacterial infections during pregnancy. UTIs are serious complications associated with risk to both the fetus and mother, including pyelonephritis, preterm birth and low birth weight.

Purpose To identify and treat pregnant women with asymptomatic and symptomatic bacteriuria.

Materials and methods 67 pregnant women at 12 – 16 weeks gestation were included. 24 of them were diagnosed with asymptomatic bacteriuria incidentally on routine urine analysis and 8 with symptomatic cystitis. The diagnosis of UTIs was based on the culture of a urine specimen collected in a manner that minimises contamination. Urine culture showed the presence of Escherichia coli in 24 women and Proteus in 8 women. The treatment was by administration of appropriate oral or parenteral antibiotics.

Results Antibiotic treatment for UTIs was initiated after all necessary cultures were obtained. 24 ambulatory women were treated with cefpodoxime 100 mg orally every 12 h for seven days. 8 pregnant women were admitted to hospital because of complications (nausea and pain) and were treated with ceftriaxone 2 g intravenous in 5% dextrose every 24 h for 5 days. Regarding cure rates and recurrent infections, the results in the ambulatory group were better than in the hospitalised group (23/5). Gestational age at birth was greater in women from the ambulatory group (21 vs 4).

Conclusion Treatment of UTIs is important. Although the study had a very small sample size The authors recommended cephalosporins for the treatment of UTIs. The administration schedule of these antibiotics is unobtrusive for the patients and complications are very rare, so they are promising antibiotics for maternal and neonatal outcomes.

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