Antibiotic prophylaxis for cesarean section

Hofmeyr, G Justus; Fm, Smaill

doi:10.1002/14651858.cd000933.pub2

Cited by 20 publications

(8 citation statements)

References 76 publications

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“…Prophylactic antibiotic reduces the incidence of endometritis, wound infection, post-partum febrile morbidity, and incidence of urinary tract infections following both elective and non-elective Caesarean section [10]. There is evidence that the routine use of prophylactic antibiotics is justified in women undergoing vaginal, abdominal or radical hysterectomy [11].…”

Section: Introductionmentioning

confidence: 99%

Misuse of prophylactic antibiotics and prevalence of postoperative wound infection in obstetrics and gynecology department in a Sudanese hospital

Elbur¹,

Yousif²,

Sayed³

et al. 2014

Health

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Purpose: This study was conducted to audit prophylactic antibiotic use and to quantify the rate of wound infection. Methods: Across-sectional prospective study was conducted in the Obstetrics and Gynecology Department in Khartoum Teaching Hospital, Sudan during March 1st to 31st October 2010. All Patients (aged >18 years) were included. Results: Overall 725 patients were included. The performed surgical procedures were 751; of these 578 (76.9%) were Caesarean sections. Overall rate of wound infection was 7.8%. The rate of wound infection among patients operated on for caesarean section and abdominal hysterectomy was 8.3%, and 9.2%, respectively. Multivariate logistic analysis showed that body mass index [BMI] ≥ 30 kg/m 2 OR 2.1, 95% CI (1.1 -4.0), (P = 0.019) was the major independent risk factor for occurrence of wound infection. Evaluation of prescriptions' parameters against the stated criteria showed that 113 (15.8%) patients were given antibiotics with adequate spectrum of activity, 611 (85.3%) given sub-dose/s, 83 (11.6%) received the first preoperative dose/s in a proper time window, and 716 (100%) had prophylaxis for extended duration. Overall conformity to the stated criteria for the evaluation of prescription's parameters was not achieved in all prescriptions. Conclusions: In this setting, antibiotics were irrationally used and wound infection rate was high, and the situation calls for multiple interventions to correct the situation, through the activation of the infection control committee in the hospital and development of antimicrobial subcommittee to develop policies for the use and auditing of prophylactic antibiotics.

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Section: Introductionmentioning

confidence: 99%

Misuse of prophylactic antibiotics and prevalence of postoperative wound infection in obstetrics and gynecology department in a Sudanese hospital

Elbur¹,

Yousif²,

Sayed³

et al. 2014

Health

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“…Much lower SSI rates have been reported in other studies. 15,16 All these trials may have underestimated the SSI rate because the follow up in these studies were only for 3-5 days. Therefore, the fact that our study involved a follow up visit at two weeks may have contributed to the higher wound infection rate.…”

Section: (16%)mentioning

confidence: 99%

Comparison of surgical site infections and patients’ comfort level with caesarean section wounds following early exposure versus delayed exposure

Chandrasiri

Fernandopullae

2016

Sri Lanka J Obstet & Gynae

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In the prevention of surgical site infections (SSIs), the ideal timing for removal of dressing remains unresolved. Objectives: To determine the outcomes of early removal of wound dressing in terms of surgical site infections (SSI), patients' comfort level and whether it was acceptable to the patients Methods: The study was conducted at the Obstetric Unit of the Professorial Unit of Colombo South Teaching Hospital from September 2012 to February 2013.Out of 498 patients assessed for eligibility, 400 were randomised using a stratified [emergency versus elective caesarean sections (CS)] design into the intervention and control groups. There were 281 and 119 patients in the emergency CS and elective CS groups respectively. In the total sample, 205 patients underwent the intervention (removal of dressing between six and 12 hours after CS) and 195 patients underwent delayed wound exposure between 24 to 30 hours after CS (controls). Patients were reviewed before discharge and in two weeks. On the 1 st post-operative day, using a visual analogue scale, their ability to sit up, get off the bed, walk and squat was assessed. The acceptability of early wound exposure was assessed in the intervention group with a structured closed ended questionnaire administered on the 1 st post-operative day Results: There was no significant difference in the SSI rates between the two groups, in both strata. Patients in the intervention group were able to perform all the given tasks more easily than in the control group (p < 0.001). Of the 183 respondents in the intervention group, 85% would prefer to have the wound dressings removed early for their next CS, 78% thought early removal of dressing improved their hygiene and 90% thought it improved their overall comfort. Conclusion: Clean, primarily sutured CS wounds ,exposed within six to 12 hours after surgery do not have an increased incidence of SSI compared to those that are exposed within 24 to 36 hours. The patients were more comfortable and better able to carry out simple tasks after early exposure compared to delayed exposure, and early exposure was well accepted by the majority of patients who had this intervention.

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“…In particular, both ampicillin and first-generation cephalosporins have similar efficacy in reducing postoperative endometritis from about 18% to 12% (a 61% decrease), with no added benefit found in using more broad-spectrum agents (110,111). 13).…”

Section: Preventionmentioning

confidence: 99%

“…Prophylactic antibiotics (either ampicillin or first-generation cephalosporin for just one dose) are associated with a 59% decrease in the incidence of wound infection compared with no antibiotics in women undergoing cesarean delivery (111). The timing for prophylaxis should be before cord clamp, as while it is not associated with significant change in neonatal outcomes (123), it reduces risk of maternal infectious morbidity (124).…”

Section: Preventionmentioning

confidence: 99%

Postpartum care^a^aIncludes breastfeeding, contraception, postpartum endometritis, and postpartum wound infection.

Stuebe¹

2012

Obstetric Evidence Based Guidelines

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Antibiotic prophylaxis for cesarean section

Abstract: Randomized and quasi-randomized trials comparing antibiotic prophylaxis to no antibiotics for caesarean section.

Cited by 20 publications

References 76 publications

Misuse of prophylactic antibiotics and prevalence of postoperative wound infection in obstetrics and gynecology department in a Sudanese hospital

Misuse of prophylactic antibiotics and prevalence of postoperative wound infection in obstetrics and gynecology department in a Sudanese hospital

Comparison of surgical site infections and patients’ comfort level with caesarean section wounds following early exposure versus delayed exposure

Postpartum care^a^aIncludes breastfeeding, contraception, postpartum endometritis, and postpartum wound infection.

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Antibiotic prophylaxis for cesarean section

Abstract: Randomized and quasi-randomized trials comparing antibiotic prophylaxis to no antibiotics for caesarean section.

Cited by 20 publications

References 76 publications

Misuse of prophylactic antibiotics and prevalence of postoperative wound infection in obstetrics and gynecology department in a Sudanese hospital

Misuse of prophylactic antibiotics and prevalence of postoperative wound infection in obstetrics and gynecology department in a Sudanese hospital

Comparison of surgical site infections and patients’ comfort level with caesarean section wounds following early exposure versus delayed exposure

Postpartum careaaIncludes breastfeeding, contraception, postpartum endometritis, and postpartum wound infection.

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Postpartum care^a^aIncludes breastfeeding, contraception, postpartum endometritis, and postpartum wound infection.