TY - JOUR
T1 - Timing of perioperative antibiotics for cesarean delivery
T2 - a metaanalysis
AU - Costantine, Maged M.
AU - Rahman, Mahbubur
AU - Ghulmiyah, Labib
AU - Byers, Benjamin D.
AU - Longo, Monica
AU - Wen, Tony
AU - Hankins, Gary D.V.
AU - Saade, George R.
N1 - Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2008/9
Y1 - 2008/9
N2 - Objective: The purpose of this study was to summarize the available evidence on timing of perioperative antibiotics for cesarean delivery. Study Design: We searched the literature for studies that compare prophylactic antibiotics for cesarean delivery that are given before the procedure vs at cord clamping. Only randomized controlled trials were included. Results: Preoperative administration significantly reduced the risk of postpartum endometritis (relative risk [RR], 0.47; 95% CI, 0.26-0.85; P = .012) and total infectious morbidity (RR, 0.50; 95% CI, 0.33-0.78; P = .002). There was a trend toward lower risk of wound infection (RR, 0.60; 95% CI, 0.30-1.21; P = .15). Preoperative administration of antibiotics did not significantly affect suspected neonatal sepsis that requires a workup (RR, 1; 95% CI, 0.70-1.42), proven sepsis (RR, 0.93; 95% CI, 0.45-1.96), or neonatal intensive care unit admissions (RR, 1.07 95% CI, 0.51-2.24). There was no significant heterogeneity between the randomized controlled trials. Conclusion: There is strong evidence that antibiotic prophylaxis for cesarean delivery that is given before skin incision, rather than after cord clamping, decreases the incidence of postpartum endometritis and total infectious morbidities, without affecting neonatal outcomes.
AB - Objective: The purpose of this study was to summarize the available evidence on timing of perioperative antibiotics for cesarean delivery. Study Design: We searched the literature for studies that compare prophylactic antibiotics for cesarean delivery that are given before the procedure vs at cord clamping. Only randomized controlled trials were included. Results: Preoperative administration significantly reduced the risk of postpartum endometritis (relative risk [RR], 0.47; 95% CI, 0.26-0.85; P = .012) and total infectious morbidity (RR, 0.50; 95% CI, 0.33-0.78; P = .002). There was a trend toward lower risk of wound infection (RR, 0.60; 95% CI, 0.30-1.21; P = .15). Preoperative administration of antibiotics did not significantly affect suspected neonatal sepsis that requires a workup (RR, 1; 95% CI, 0.70-1.42), proven sepsis (RR, 0.93; 95% CI, 0.45-1.96), or neonatal intensive care unit admissions (RR, 1.07 95% CI, 0.51-2.24). There was no significant heterogeneity between the randomized controlled trials. Conclusion: There is strong evidence that antibiotic prophylaxis for cesarean delivery that is given before skin incision, rather than after cord clamping, decreases the incidence of postpartum endometritis and total infectious morbidities, without affecting neonatal outcomes.
KW - antibiotics
KW - cesarean delivery
KW - endometritis
KW - infectious morbidity
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U2 - 10.1016/j.ajog.2008.06.077
DO - 10.1016/j.ajog.2008.06.077
M3 - Article
C2 - 18771991
AN - SCOPUS:50349097317
SN - 0002-9378
VL - 199
SP - 301.e1-301.e6
JO - American journal of obstetrics and gynecology
JF - American journal of obstetrics and gynecology
IS - 3
ER -