Antimicrobial resistance (AMR) represents one of the most formidable global health threats of the 21 st century, undermining decades of progress in maternal and neonatal care. Obstetrics and gynaecology (OBG) is a speciality with substantial antimicrobial exposure owing to its high procedural volume, routine use of prophylactic antibiotics and frequent management of infections across pregnancy, childbirth, abortion care and gynaecologic surgery. While antimicrobial stewardship (AMS) programmes have gained momentum in general medicine and critical care, their systematic integration into OBG remains limited. This narrative review critically examines the burden of AMR in OBG, the unique vulnerability of pregnant women to infection and sepsis, and the far-reaching consequences of antimicrobial misuse on neonatal health. It further explores common patterns of inappropriate antibiotic use, evidence-based stewardship frameworks applicable to OBG practice, and the importance of integrating AMS with infection prevention strategies. Emerging diagnostic technologies and novel therapeutic approaches that may reconcile early sepsis management with judicious antimicrobial use are also discussed. Strengthening antimicrobial stewardship in OBG is not only a clinical necessity but also an ethical imperative to safeguard maternal safety, neonatal health, and the effectiveness of antibiotics for future generations.
Vijayan et al. (Mon,) studied this question.