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The impact of low-dose versus high-dose antibiotic prophylaxis regimens on surgical site infection rates after cesarean delivery

Archives of Gynecology and Obstetrics volume 301, pages 69–73 (2020)Cite this article

Abstract

Objective

The objective of this study was to determine if high-dose antibiotic prophylaxis with cefazolin decreases the risk of surgical site infection (SSI) after a cesarean delivery.

Methods

We performed a retrospective cohort study of women who underwent a cesarean section. Two preoperative antibiotic regimens were compared: low dose versus high dose. The primary outcome was SSI. A sample size of 343 patients per group was calculated for a 50% reduction in risk for SSI.

Results

Seven hundred and thirty women were included with an incidence of SSI of 5%. Women who received the high-dose antibiotic regimen had lower rates of risk factors for SSI. The only exception was skin incision closure with staples. The rate of SSI did not differ between the low-dose and high-dose groups, even after adjusting for confounding variables [aOR 1.78, 95% CI (0.82–3.9)].

Conclusions

Higher doses of antibiotic prophylaxis did not decrease the rates of SSI after cesarean delivery.

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Acknowledgements

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Affiliations

  1. The Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston, 301 University Boulevard, Galveston, TX, 77555-0587, USA

    Mauricio La Rosa, Chasey Omere, Tiffany Redfern, Mahmoud Abdelwahab, Nicholas Spencer, Josephine Villarreal, Gayle Olson, George R. Saade & Antonio F. Saad

Authors
  1. Mauricio La Rosa
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  2. Chasey Omere
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  3. Tiffany Redfern
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  4. Mahmoud Abdelwahab
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  5. Nicholas Spencer
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  6. Josephine Villarreal
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  7. Gayle Olson
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  8. George R. Saade
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  9. Antonio F. Saad
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Contributions

MLR project development, data collection, manuscript writing, data analysis. CO project development, data collection. TR project development, data collection. MA project development, data collection. NS project development, data collection. JV project development, data collection. GO project development, manuscript writing, data analysis. GS project development, manuscript writing, data analysis. AS project development, data collection, manuscript writing, data analysis.

Corresponding author

Correspondence to Mauricio La Rosa.

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Conflict of interest

The authors report no conflicts of interest.

Research involving human participants

The protocol was reviewed by the University of Texas Medical Branch Galveston Hospital Institutional Review Board, our research project (IRB protocol #16-0204) and found to meet the exemption criteria and review was waived.

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No informed consent was required.

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La Rosa, M., Omere, C., Redfern, T. et al. The impact of low-dose versus high-dose antibiotic prophylaxis regimens on surgical site infection rates after cesarean delivery. Arch Gynecol Obstet 301, 69–73 (2020). https://doi.org/10.1007/s00404-019-05370-y

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  • DOI: https://doi.org/10.1007/s00404-019-05370-y

Keywords

  • Antibiotics
  • Cesarean
  • Infection
  • Pregnancy
  • Prophylaxis
  • Wound