Antimicrobial Prophylaxis in pregnancy : Phase 2 Data

Project Partners

Choosing Wisely Canada

Alberta Health Services (implied through Alberta context)

Clinical teams from primary care, obstetrical/midwifery care, and tertiary care settings

Research and data analysis teams involved in administrative health data review

Background

Optimizing antimicrobial use during pregnancy is vital for maternal and neonatal health. Despite this, many pregnant individuals are prescribed non-beta lactam antibiotics due to incorrect penicillin allergy labels. Choosing Wisely Canada highlights that most of these patients can safely receive penicillin. Misuse of antibiotics elevates risks such as surgical site infections, C. difficile, prolonged hospital stays, and neonatal colonization with resistant organisms.

Aims/Objectives

Improve antimicrobial use in perinatal care through accurate allergy assessment

Identify barriers to appropriate antibiotic prescribing

Analyze local practices across care environments

Develop and implement evidence-based, targeted interventions

Promote guideline-concordant antibiotic prophylaxis for better health outcomes

Findings/Summary

In Alberta, 10,000–15,000 pregnant individuals receive antibiotic prophylaxis annually during labor and delivery. The first phase of the project assessed clinical practices and workflows, while the second phase involved secondary analysis of administrative health data across care settings—primary, specialty, and tertiary care. This analysis identified variations in practice and highlighted areas of non-concordance with established guidelines. The baseline data will guide future intervention efforts by prioritizing areas with the greatest need and potential impact. A final report has been completed, and preparation of a scholarly manuscript is underway. Results from both data analysis and process mapping will inform the next stage: targeted knowledge translation strategies.

Conclusions/Outcomes/Impact/Implications

This project lays the foundation for evidence-based interventions to improve antimicrobial stewardship in pregnancy. It supports enhanced guideline adherence, reduces unnecessary broad-spectrum antibiotic use, and contributes to safer outcomes for mothers and infants. The findings will drive future quality improvement and knowledge translation initiatives across multiple healthcare settings.