Effect of a change in policy regarding the timing of prophylactic antibiotics on the rate of postcesarean delivery surgical-site infections

Anjali J. Kaimal, Marya G. Zlatnik, Yvonne W. Cheng, Mari Paule Thiet, Elspeth Connatty, Patricia Creedy, Aaron Caughey

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

Objective: The purpose of this study was to examine the effect of a change in policy regarding the timing of antibiotic administration on the rates of postcesarean delivery surgical-site infections (SSI). Study Design: This was a retrospective cohort study of 1316 term, singleton cesarean deliveries at 1 institution. A policy change was instituted wherein prophylactic antibiotics were given before skin incision rather than after cord clamp. The primary outcome that was examined was SSI; secondary outcomes were the rates of endometritis and cellulitis. Multivariable regression was performed to control for potential confounders. Results: The overall rate of SSI fell from 6.4-2.5% (P = .002). When we controlled for potential confounders, there was a decline in overall SSI with an adjusted odds ratio (aOR) of 0.33 (95% CI, 0.14,0.76), a decrease in endometritis (aOR, 0.34; 95% CI, 0.13,0.92), and a trend towards a decrease in cellulitis (aOR, 0.22; 95% CI, 0.05,1.22). Conclusion: At our institution, a change in policy to administer prophylactic antibiotics before skin incision led to a significant decline in postcesarean delivery SSIs.

Original languageEnglish (US)
JournalAmerican Journal of Obstetrics and Gynecology
Volume199
Issue number3
DOIs
StatePublished - Sep 2008
Externally publishedYes

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Surgical Wound Infection
Anti-Bacterial Agents
Endometritis
Cellulitis
Odds Ratio
Skin
Cohort Studies
Retrospective Studies

Keywords

  • evidence-based medicine
  • infection
  • surgical complication
  • systems-based practice

ASJC Scopus subject areas

  • Medicine(all)
  • Obstetrics and Gynecology

Cite this

Effect of a change in policy regarding the timing of prophylactic antibiotics on the rate of postcesarean delivery surgical-site infections. / Kaimal, Anjali J.; Zlatnik, Marya G.; Cheng, Yvonne W.; Thiet, Mari Paule; Connatty, Elspeth; Creedy, Patricia; Caughey, Aaron.

In: American Journal of Obstetrics and Gynecology, Vol. 199, No. 3, 09.2008.

Research output: Contribution to journalArticle

Kaimal, Anjali J. ; Zlatnik, Marya G. ; Cheng, Yvonne W. ; Thiet, Mari Paule ; Connatty, Elspeth ; Creedy, Patricia ; Caughey, Aaron. / Effect of a change in policy regarding the timing of prophylactic antibiotics on the rate of postcesarean delivery surgical-site infections. In: American Journal of Obstetrics and Gynecology. 2008 ; Vol. 199, No. 3.
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