Effectiveness of Antimicrobial Prophylaxis at 30 Versus 60 min Before Cesarean Delivery

Overview

Journal Sci Rep

Specialty Science

Date 2021 Apr 17

PMID 33863969

Citations 1

Authors

Hadas Rubin

Eyal Rom

Malak Wattad

Khadeje Seh

Natanel Levy

Ayellet Jehassi

Shabtai Romano

Raed Salim

Affiliations

Soon will be listed here.

Abstract

This study aimed to examine the effect of antibiotic prophylaxis (AP) given within 30 compared to 30-60 min before skin incision on the incidence of infectious morbidity after cesarean delivery (CD). A retrospective cohort study was conducted at a single institution on data between 2014 and 2018. Women who delivered by CD were divided into two groups according to AP timing before skin incision: group 1 within 30 min, and group 2 from 30 to 60 min. The primary outcome was the incidence of any infectious morbidity. Overall, 2989 women were eligible: 2791 in group 1 and 198 in group 2. The primary composite outcome occurred in 125 women (4.48%) in group 1 and 8 women (4.04%) in group 2 (OR, 1.11; 95% CI 0.54-2.31; P = 0.77). The rate of surgical site infection only, was 1.08% in group 1 and 0.51% in group 2 (OR, 2.13; 95% CI 0.29-15.70; P = 0.72). The incidence was comparable between the groups in a separate sub-analysis restricted to laboring CDs and obese women. The rate of infectious morbidity was similar among women who received AP within 30 min and from 30 to 60 min before skin incision.

Citing Articles

Pathogenic Spectrum and Resistance Pattern of Bloodstream Infections Isolated from Postpartum Women: A Multicenter Retrospective Study.

Zou Q, Zou H, Shen Y, Yu L, Zhou W, Sheng C Infect Drug Resist. 2021; 14:2387-2395.

PMID: 34211283 PMC: 8241814. DOI: 10.2147/IDR.S315367.

References

Thigpen B, Hood W, Chauhan S, Bufkin L, Bofill J, Magann E . Timing of prophylactic antibiotic administration in the uninfected laboring gravida: a randomized clinical trial. Am J Obstet Gynecol. 2005; 192(6):1864-8. DOI: 10.1016/j.ajog.2004.12.063. View

Mugford M, Kingston J, Chalmers I . Reducing the incidence of infection after caesarean section: implications of prophylaxis with antibiotics for hospital resources. BMJ. 1989; 299(6706):1003-6. PMC: 1837925. DOI: 10.1136/bmj.299.6706.1003. View

Heikkila A, Erkkola R . Review of beta-lactam antibiotics in pregnancy. The need for adjustment of dosage schedules. Clin Pharmacokinet. 1994; 27(1):49-62. DOI: 10.2165/00003088-199427010-00005. View

Smaill F, Grivell R . Antibiotic prophylaxis versus no prophylaxis for preventing infection after cesarean section. Cochrane Database Syst Rev. 2014; (10):CD007482. PMC: 8078551. DOI: 10.1002/14651858.CD007482.pub3. View

Baaqeel H, Baaqeel R . Timing of administration of prophylactic antibiotics for caesarean section: a systematic review and meta-analysis. BJOG. 2012; 120(6):661-9. PMC: 3654161. DOI: 10.1111/1471-0528.12036. View

Salim R, Braverman M, Teitler N, Berkovic I, Suliman A, Shalev E . Risk factors for infection following cesarean delivery: an interventional study. J Matern Fetal Neonatal Med. 2012; 25(12):2708-12. DOI: 10.3109/14767058.2012.705394. View

Dinsmoor M, Gilbert S, Landon M, Rouse D, Spong C, Varner M . Perioperative antibiotic prophylaxis for nonlaboring cesarean delivery. Obstet Gynecol. 2009; 114(4):752-756. PMC: 2863989. DOI: 10.1097/AOG.0b013e3181b8f28f. View

Weber W, Marti W, Zwahlen M, Misteli H, Rosenthal R, Reck S . The timing of surgical antimicrobial prophylaxis. Ann Surg. 2008; 247(6):918-26. DOI: 10.1097/SLA.0b013e31816c3fec. View

Pencina M, DAgostino R, Massaro J . Understanding increments in model performance metrics. Lifetime Data Anal. 2012; 19(2):202-18. PMC: 3656609. DOI: 10.1007/s10985-012-9238-0. View

10.

Hamilton B, Martin J, Osterman M, Curtin S, Matthews T . Births: Final Data for 2014. Natl Vital Stat Rep. 2016; 64(12):1-64. View

11.

Chelmow D, Ruehli M, Huang E . Prophylactic use of antibiotics for nonlaboring patients undergoing cesarean delivery with intact membranes: a meta-analysis. Am J Obstet Gynecol. 2001; 184(4):656-61. DOI: 10.1067/mob.2001.111303. View

12.

. ACOG Practice Bulletin No. 199 Summary: Use of Prophylactic Antibiotics in Labor and Delivery. Obstet Gynecol. 2018; 132(3):798-800. DOI: 10.1097/AOG.0000000000002834. View

13.

Elkomy M, Sultan P, Drover D, Epshtein E, Galinkin J, Carvalho B . Pharmacokinetics of prophylactic cefazolin in parturients undergoing cesarean delivery. Antimicrob Agents Chemother. 2014; 58(6):3504-13. PMC: 4068446. DOI: 10.1128/AAC.02613-13. View

14.

Costantine M, Rahman M, Ghulmiyah L, Byers B, Longo M, Wen T . Timing of perioperative antibiotics for cesarean delivery: a metaanalysis. Am J Obstet Gynecol. 2008; 199(3):301.e1-6. DOI: 10.1016/j.ajog.2008.06.077. View

15.

Perencevich E, Sands K, Cosgrove S, Guadagnoli E, Meara E, Platt R . Health and economic impact of surgical site infections diagnosed after hospital discharge. Emerg Infect Dis. 2003; 9(2):196-203. PMC: 2901944. DOI: 10.3201/eid0902.020232. View

16.

Moulton L, Munoz J, Lachiewicz M, Liu X, Goje O . Surgical site infection after cesarean delivery: incidence and risk factors at a US academic institution. J Matern Fetal Neonatal Med. 2017; 31(14):1873-1880. DOI: 10.1080/14767058.2017.1330882. View

17.

Bollig C, Nothacker M, Lehane C, Motschall E, Lang B, Meerpohl J . Prophylactic antibiotics before cord clamping in cesarean delivery: a systematic review. Acta Obstet Gynecol Scand. 2017; 97(5):521-535. DOI: 10.1111/aogs.13276. View

18.

D Dahlke J, Mendez-Figueroa H, Rouse D, Berghella V, Baxter J, Chauhan S . Evidence-based surgery for cesarean delivery: an updated systematic review. Am J Obstet Gynecol. 2013; 209(4):294-306. DOI: 10.1016/j.ajog.2013.02.043. View

19.

Sullivan S, Smith T, Chang E, Hulsey T, VanDorsten J, Soper D . Administration of cefazolin prior to skin incision is superior to cefazolin at cord clamping in preventing postcesarean infectious morbidity: a randomized, controlled trial. Am J Obstet Gynecol. 2007; 196(5):455.e1-5. DOI: 10.1016/j.ajog.2007.03.022. View

20.

Classen D, Evans R, Pestotnik S, Horn S, Menlove R, Burke J . The timing of prophylactic administration of antibiotics and the risk of surgical-wound infection. N Engl J Med. 1992; 326(5):281-6. DOI: 10.1056/NEJM199201303260501. View