BACKGROUND: Adult vaccination is necessary in the prevention of many of the most common infectious diseases because immunity from infant vaccination typically wanes in adulthood In the female population the obstetrician gynecologist is placed at the forefront of health promotion and disease prevention In 2011 the Philippine Obstetrics and Gynecology Society POGS released a Clinical Practice Guideline on Immunization for Filipino Women but no study has been done to determine its impact
OBJECTIVE: This study determined the awareness and practices of OB GYN specialists on adult vaccination and their perceived hindrances to routine administration of the recommended vaccines METHODS: A self administered questionnaire was given to the POGS fellows through email phone and personal visits
RESULTS: Almost all of the respondents 95 were aware of Clinical Practice Guideline on Immunization but only 4 of the OB GYNs routinely administered all the vaccines The most common vaccinne administered was Human Papilloma Virus HPV vaccine 42 7 followed by Influenza virus vaccine 28 1 and Hepatitis B vaccine 27 3 There is no significant relationship between age of the respondent the number of years in practice place of practice affiliation with a teaching hospital or subspeciality training and vaccine recommendation and administration There is a significant positive relationship between awareness of the guidelines and the frequency of recommending the Tetanus Diphtheria Pertussis Tdap vaccine and the Influenza vaccine Similarly awareness of the guidelines was related to increased frequency of administering the Human Papilloma Virus HPV vaccine and the Influenza vaccine
CONCLUSION: Hence adult vaccination coverage may be promoted by increasing the awareness of the obstetrician gynecologists of the POGS Clinical Practice Guidelines on Immunization Although cost remains to be an issue identified by 93 of the respondents increasing awareness among OB GYNs on the importance of adult vaccination through the CPG on Immunization and or through attendance of the Vaccinology 101 Course through vaccinology courses may ultimately help decrease the incidence of some of the most coomon infectious diseases affecting the Filipino women and their children.

Human ; Male ; Female ; Middle Aged ; Adult ; Diphtheria-tetanus-pertussis Vaccine ; Influenza Vaccines ; Hepatitis B Vaccines ; Tetanus ; Diphtheria ; Vaccination ; Immunization ; Papillomavirus Vaccines ; Papillomaviridae

BACKGROUND: Antimicrobial therapy is an integral part of an acceptable clinical practice in Obstetrics and Gynecology. However, in order for these antimicrobials to deliver the desired clinical outcome, the practice of judicious antibiotic stewardship should be observed. The objective of the study was 1.) To determine the proportion of pregnant women admitted at the Department of Obstetrics and Gynecology who received antibiotics from January 1, 2018 to December 31, 2018, 2.) To determine the proportion of indications for antibiotic administration, 3.) To determine if indications for antimicrobial usage is in accordance with the clinical case, policy guidelines, culture results and antibiogram report, 4.) To determine the percentage of cases not given antimicrobials that should have been started on antimicrobial therapy, 5.) To compare the association of the clinical outcomes among patients given and not given antimicrobials, 6.) To compare the association of the immediate neonatal outcomes among pregnant patients given and not given antimicrobials. METHODS: A retrospective cohort study was done covering a period of 1 year from January to December 2018. The study included all pregnant patients who were admitted and listed based from the master list of the Department of Obstetrics and Gynecology. Included are all the retrieval charts from the records sections whereas gynecologic and those cases with medical records not retrieved were excluded. A total of 3,495 obstetrics patients admitted from January to December 2018 were retrospectively studied. From this group, the complete medical records of 1,092 obstetrics patients were retrieved and included in this study. Detailed clinical information, antibiotics administered, diagnostic and other relevant investigations, and clinical outcomes were recorded from case sheets. After the data were collected from patients' medical records, datas were manually entered into an electronic spreadsheet file, and the data processing and analysis were then carried out using statistical software Stata 13. RESULTS: There were 1,092 women included in the current study with more than half of them administered or received antibiotics as part of their regimen (n = 663, 60.71 %) compared to those not administered antibiotics (n = 429, 39.29%). The results showed that the prevalence of obstetric patients (undelivered, delivered, ectopic pregnancy and abortion) prescribed and given antibiotics was between 57.75 to 63.62 per cent. There was no association between the comparison groups in terms of age (x 2 : 3.62, p: 0.31 ), marital status (x2 : 1.29, p: 0.26), body mass index classification (x 2 : 6.88, p: 0.08), hemoglobin level (x 2 : 1.74, p: 0.19), and number of prenatal consults (x2 : 3.13, p: 0.21 . There was a significantly higher proportion of women who delivered abdominally that were administered antibiotics (x 2 : 32.45, p<0.01) as compared to women who delivered vaginally (spontaneous or assisted), admitted due to ectopic pregnancy, abortion, and medical management. Cephalosporins are the most widely used antibiotics. Cefazolin (60.48%) followed by Cefuroxime (39.97%) were commonly used for pre-operative prophylaxis and urinary tract infection. Other commonly used antibiotics are Clindamycin (3.62%), Ampicillin (3.47%), Amikacin (2.56%), Ceftriaxone (2.11 %) and Doxycycline (1 .81 %). In 803 of cases (74.15%), reason for administration was not recorded in the chart and stated on working impression and final diagnosis. Majority of the antibiotics were empirically given (99.10%). The irrational use of antibiotics among those administered was observed in 564 cases (52.47%) (95% Cl: 49.46-55.47%). Rational use was only observed in 99 cases (19.08%). Among those not given antibiotics, 420 cases (80.92%) with adherence to antibiotic guidelines and 9 cases (52.47%) inappropriately not given antibiotics. It can also be noticed that there was an association between administration (and nonadministration) of antibiotics - and having an appropriate indication for such action (x2: 718.97, p<0.01 ). Maternal and neonatal outcomes showed that there was no noted association between the administration of antibiotics, and selected outcomes. Additional morbidity appeared to be slightly increased among those who were not given antibiotics than otherwise (z: -1.90, p: 0.60). CONCLUSION The study demonstrated that most of the antibiotic administration from January 1 to December 31, 2018