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Am J Infect Control. 2010 Oct;38(8):612-6. doi: 10.1016/j.ajic.2010.02.013. Epub 2010 Jun 3.

Post-cesarean delivery infectious morbidity: Focus on preoperative antibiotics and methicillin-resistant Staphylococcus aureus.

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  • 1Department of Obstetrics and Gynecology, Eastern Virginia Medical School, CONRAD Clinical Research Center, Norfolk, VA 23507, USA. thurmaar@evms.edu

Abstract

BACKGROUND:

Randomized controlled trials show that administering preoperative antibiotics prior to cesarean delivery (CD) significantly reduces the incidence of post-CD infectious morbidity. Methicillin-resistant Staphylococcus aureus (MRSA) has become prevalent in obstetrics and gynecology. The objective of this trial is to examine infectious morbidity in a clinical setting before versus after implementation of a preoperative antibiotic policy and, further, to describe the organisms cultured from CD wound infections.

METHODS:

We used a retrospective chart review of women delivering by CD before and after implementation of preoperative antibiotic policy.

RESULTS:

Prior to instituting the preoperative antibiotic policy, the incidence of post-CD infectious morbidity was 20.7% and dropped to 8.5% after the policy was established (P < .001). Study cohorts were similar (P > .05) in several risk factors for infection. MRSA was the most common organism isolated from post-CD wound infections (18/34, 53%). Endomyometritis accounted for the majority of post-CD infections (143/191, 74.9%), and most infections occurred within 7 days of CD (170/191, 89.0%).

CONCLUSION:

The incidence of post-CD infectious complications decreased after a policy of administering preoperative antibiotics was instituted. MRSA was the most common organism isolated from post-CD wound infections. Further studies into the benefit of MRSA coverage in CD preoperative antibiotic regimens are needed.

Copyright © 2010 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

PMID:
20627452
[PubMed - indexed for MEDLINE]
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