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Vol. 75, No. 3, 2013
Issue release date: April 2013
Section title: Original Article
Gynecol Obstet Invest 2013;75:175-178
(DOI:10.1159/000346458)

Prophylactic Administration of Cefazolin Prior to Skin Incision versus Antibiotics at Cord Clamping in Preventing Postcesarean Infectious Morbidity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Sun J. · Ding M. · Liu J. · Li Y. · Sun X. · Liu T. · Chen Y. · Liu J.
aDepartment of Obstetrics, and bAssisted Reproductive Center, Linyi People's Hospital, Linyi, and cDepartment of Obstetrics, First Affiliated Hospital, Chongqing Medical University, Chongqing, China

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Article / Publication Details

First-Page Preview
Abstract of Original Article

Received: 6/26/2012 10:42:54 AM
Accepted: 12/12/2012 12:42:21 PM
Published online: 2/21/2013

Number of Print Pages: 4
Number of Figures: 0
Number of Tables: 0

ISSN: 0378-7346 (Print)
eISSN: 1423-002X (Online)

For additional information: http://www.karger.com/GOI

Abstract

Background/Aim: To summarize the published evidence of prophylactic cefazolin for cesarean delivery given before the procedure versus at cord clamping. Methods: We systematically searched the databases of PubMed, Embase, and CENTRAL in the Cochrane Library for randomized controlled trials that compared prophylactic antibiotics with cefazolin for cesarean delivery given before the procedure versus at cord clamping. Results: Six randomized controlled trials with high quality were included in this meta-analysis. Preoperative administration significantly reduced the risk of postpartum endometritis (RR: 0.57, 95% CI: 0.36-0.90, p = 0.02). Preoperative administration of cefazolin was not associated with a significant reduction in the risk of wound infection (RR: 0.70, 95% CI: 0.43-1.12) and urinary tract infection (RR: 1.19, 95% CI: 0.53-2.63). Furthermore, preoperative administration of cefazolin did not significantly affect proven neonatal sepsis (RR: 0.82, 95% CI: 0.47-1.42), suspected neonatal sepsis that requires a workup (RR: 0.94, 95% CI: 0.72-1.22), or neonatal intensive care unit admissions (RR: 0.90, 95% CI: 0.62-1.28). Conclusion: Pooled results demonstrated that antibiotic prophylaxis with cefazolin for cesarean delivery that is given before skin incision can significantly decrease the incidence of postpartum endometritis.


Article / Publication Details

First-Page Preview
Abstract of Original Article

Received: 6/26/2012 10:42:54 AM
Accepted: 12/12/2012 12:42:21 PM
Published online: 2/21/2013

Number of Print Pages: 4
Number of Figures: 0
Number of Tables: 0

ISSN: 0378-7346 (Print)
eISSN: 1423-002X (Online)

For additional information: http://www.karger.com/GOI


Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Henderson E, Love EJ: Incidence of hospital-acquired infections associated with caesarean section. J Hosp Infect 1995;29:245-255.
  2. Killian CA, Graffunder EM, Vinciguerra TJ, et al: Risk factors for surgical-site infections following cesarean section. Infect Control Hosp Epidemiol 2001;22:613-617.
  3. Hager RM, Daltveit AK, Hofoss D, et al: Complications of cesarean deliveries: rates and risk factors. Am J Obstet Gynecol 2004;190:428-434.
  4. Myles TD, Gooch J, Santolaya J: Obesity as an independent risk factor for infectious morbidity in patients who undergo cesarean delivery. Obstet Gynecol 2002;100:959-964.
  5. Classen DC, Evans RS, Pestotnik SL, et al: The timing of prophylactic administration of antibiotics and the risk of surgical-wound infection. N Engl J Med 1992;326:281-286.
  6. ASHP therapeutic guidelines on antimicrobial prophylaxis in surgery: American Society of Health-System Pharmacists. Am J Health Syst Pharm 1999;56:1839-1888.

    External Resources

  7. Smaill F, Hofmeyr GJ: Antibiotic prophylaxis for cesarean section. Cochrane Database Syst Rev 2002;3:CD000933.
  8. Smaill FM, Gyte GM: Antibiotic prophylaxis versus no prophylaxis for preventing infection after cesarean section. Cochrane Database Syst Rev 2010;1:CD007482.
  9. ACOG practice bulletin No. 47, October 2003: prophylactic antibiotics in labor and delivery. Obstet Gynecol 2003;102:875-882.
  10. Fejgin MD, Markov S, Goshen S, et al: Antibiotic for cesarean section: the case for ‘true' prophylaxis. Int J Gynaecol Obstet 1993;43:257-261.
  11. Cunningham FG, Leveno KJ, DePalma RT, et al: Perioperative antimicrobials for cesarean delivery: before or after cord clamping? Obstet Gynecol 1983;62:151-154.

    External Resources

  12. Sullivan SA, Smith T, Chang E, et al: Administration of cefazolin prior to skin incision is superior to cefazolin at cord clamping in preventing postcesarean infectious morbidity: a randomized, controlled trial. Am J Obstet Gynecol 2007;196:455.e1-5.
  13. Thigpen BD, Hood WA, Chauhan S, et al: Timing of prophylactic antibiotic administration in the uninfected laboring gravida: a randomized clinical trial. Am J Obstet Gynecol 2005;192:1864-1868, discussion 1868-1871.
  14. Wax JR, Hersey K, Philput C, et al: Single dose cefazolin prophylaxis for postcesarean infections: before vs. after cord clamping. J Matern Fetal Med 1997;6:61-65.
  15. Yildirim G, Gungorduk K, Guven HZ, et al: When should we perform prophylactic antibiotics in elective cesarean cases? Arch Gynecol Obstet 2009;280:13-18.
  16. Witt A, Doner M, Petricevic L, et al: Antibiotic prophylaxis before surgery vs after cord clamping in elective cesarean delivery: a double-blind, prospective, randomized, placebo-controlled trial. Arch Surg 2011;146:1404-1409.
  17. Macones GA, Cleary KL, Parry S, et al: The timing of antibiotics at cesarean: a randomized controlled trial. Am J Perinatol 2012;29:273-276.
  18. Kjaergard LL, Villumsen J, Gluud C: Reported methodologic quality and discrepancies between large and small randomized trials in meta-analyses. Ann Intern Med 2001;135:982-989.

    External Resources

  19. Moher D, Pham B, Jones A, et al: Does quality of reports of randomised trials affect estimates of intervention efficacy reported in meta-analyses? Lancet 1998;352:609-613.
  20. Wood L, Egger M, Gluud LL, et al: Empirical evidence of bias in treatment effect estimates in controlled trials with different interventions and outcomes: meta-epidemiological study. BMJ 2008;336:601-605.
  21. Costantine MM, Rahman M, Ghulmiyah L, et al: Timing of perioperative antibiotics for cesarean delivery: a metaanalysis. Am J Obstet Gynecol 2008;199:301.e1-e6.