Antibiotic Use and Preterm Labor: Attitudes and Practice Patterns of North Carolina Obstetric Providers

Abstract

Background:

Despite the reported link between subclinical genital tract infection (GTI) and preterm labor (PTL), it is not certain that treating PTL empirically with antibiotics decreases neonatal morbidity and mortality. This study describes the beliefs of family physicians and nurse-midwives regarding the link between subclinical GTI and PTL and their use of empiric antibiotics to treat spontaneous PTL.

Methods:

This was a survey of family physicians, family practice residents, and midwives (n = 588) who practice obstetrics in North Carolina. The response rate was 61%.

Results:

Ninety-six percent of providers search for GTI, and 76% believe antibiotics for presumed infection will benefit the neonate. Wide variation in the use of antibiotics exists within groups and between groups of providers. Nurse-midwives are more likely than family physicians to use broad-spectrum antibiotics (p < 0.001).

Conclusions:

Family physicians and nurse-midwives are uncertain about the optimal management of PTL. Empiric antibiotic use varies widely despite the lack of supportive data.