Impact of extended-spectrum antibiotic prophylaxis on incidence of postcesarean surgical wound infection

Am J Obstet Gynecol. 2008 Sep;199(3):303.e1-3. doi: 10.1016/j.ajog.2008.06.068.

Abstract

Objective: We assessed the impact of an extended-spectrum antibiotic prophylaxis regimen (azithromycin in addition to recommended narrow-spectrum cephalosporin) on postcesarean incisional wound infection.

Study design: Data from prospective surveillance of surgical site infections at our institution were used to compare incidence in postcesarean incisional wound infection for 3 consecutive time periods of antibiotic prophylaxis: (1) standard (ie, cephalosporin only, 1992-1996); (2) clinical trial of extended spectrum (ie, extended vs cephalosporin only, 1997-1999); and (3) routine use of extended spectrum (2001-2006).

Results: The incidence of postcesarean incisional wound infections decreased progressively from 3.1% to 2.4% and then to 1.3% over the 3 consecutive periods (P value for trend < .002).

Conclusion: Increasing the use of extended-spectrum antibiotic prophylaxis at our institution over 3 time periods was associated with a decreasing trend in postcesarean incisional wound infection.

MeSH terms

  • Adult
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use*
  • Antibiotic Prophylaxis*
  • Azithromycin / therapeutic use*
  • Cephalosporins / administration & dosage
  • Cephalosporins / therapeutic use*
  • Cesarean Section*
  • Drug Therapy, Combination
  • Female
  • Humans
  • Incidence
  • Pregnancy
  • Surgical Wound Infection / epidemiology
  • Surgical Wound Infection / prevention & control*

Substances

  • Anti-Bacterial Agents
  • Cephalosporins
  • Azithromycin