Antibiotic prophylaxis for cesarean delivery: survey of maternal-fetal medicine physicians in the U.S.

Abstract

Objective To briefly describe practices concerning antibiotic prophylaxis for cesarean delivery among maternal-fetal medicine (MFM) physicians in the United States (US). Methods A 10-item self-administered survey about their routine use of antibiotics for cesarean delivery was mailed once only to a random sample of 1000 US-based fellows of the Society of Maternal-Fetal Medicine (SMFM) in November 2009. Results There were a total of 250 respondents from 40 US states between 10/09 and 4/2010, corresponding to a response rate of 25%. Among respondents, 95.5% reported routine use of a cephalosporin only (including 84.4% who reported use of cefazolin) as antibiotic prophylaxis for cesarean delivery; less than 3% reported use of an extended spectrum regimen such as cefazolin+azithromycin. Pre-incision administration of antibiotics was reported by 83.6% compared to 15.0% who reported giving prophylactic antibiotics after umbilical cord clamp. Administration of a single dose of antibiotics was reported by 96%. Conclusion The majority of MFM specialists in the US report routine use of a single prophylactic dose of a 1st generation cephalosporin prior to incision for cesarean delivery.

The effect of antibiotic prophylaxis guidelines on surgical‐site infections associated with cesarean delivery

“…A survey of maternal–fetal medicine physicians in the USA [14] found that only 2 (0.8%) of 245 respondents did not use routine antibiotics during CD. Approximately 95% of the physicians who used antibiotic prophylaxis stated that their drug of choice was either a first‐ or second‐generation cephalosporin; 85% administered antibiotics before incision, in line with the recommendations of the American College of Obstetricians and Gynecologists [15].…”

Timing of administration of prophylactic antibiotics for caesarean section: a systematic review and meta‐analysis

“…Prophylactic antibiotics for caesarean section are commonly used worldwide, and in most institutions a single dose is administered, generally after clamping of the umbilical cord . However, a recent survey (published in 2011) of maternal and fetal medicine physicians in the USA revealed that 84% of those who responded (the response rate was 25%) used preoperative administration . The effectiveness of prophylactic antibiotics depends on their presence in effective concentrations throughout the operative period.…”

Prophylactic ceftizoxime for elective cesarean delivery at Soba Hospital, Sudan

“…It has been advised that prophylactic antibiotics should be given before surgical incision to prevent post-operative surgical infections [6]; an exception in this generalization is the cesarean delivery, where the recommendation is to use prophylactic antibiotics after clamping of the umbilical cord. A recent survey that described practice of antibiotic prophylaxis for cesarean delivery among American maternal-fetal medicine physicians showed that; preoperative administration of antibiotic prophylaxis was the commonest practice which was reported by 84.6% of the physician compared to 15.0% who reported giving antibiotic prophylaxis after umbilical cord clamping [14]. …”