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

Timing of antibiotic administration and infectious morbidity following cesarean delivery: incorporating policy change into workflow

“…Our study demonstrates a trend towards a lower total infectious morbidity among consecutive patients receiving prophylactic antibiotics before skin incision regardless of indication for or urgency of cesarean delivery. Our results show a benefit of antibiotics administered before skin incision, particularly for the prevention of endometritis, similar to other recent well-designed studies [9,10,13].…”

“…This approach also was successful in our institution when implementing a large-scale process change with the transition to the use of fetal heart rate tracing categories [15]. Several studies have shown that administering antibiotics before skin incision resulted in lower incidence of infectious complications following cesarean delivery [9,10,13]. Our study demonstrates a trend towards a lower total infectious morbidity among consecutive patients receiving prophylactic antibiotics before skin incision regardless of indication for or urgency of cesarean delivery.…”

“…In addition, recent literature indicates that administering antibiotics before skin incision more effectively prevents postpartum surgical-site infection, including endometritis and cellulitis, following cesarean delivery than antibiotics administered after cord clamping [9,10,13]. A 2010 Cochrane metaanalysis supported the use of surgical antibiotic prophylaxis, although it found inconclusive data to support antibiotic administration before skin incision.…”

A multifaceted prevention program to reduce infection after cesarean section: Interventions assessed using an intensive postdischarge surveillance system

“…Optimal timing of antibiotic prophylaxis is also important to reduce SSIs after CS, particularly when the prophylactic antibiotic is given within 60 minutes of incision versus after cord clamping. [27][28][29] Neonatal concerns are often cited to justify the practice of administering prophylactic antibiotics after cord clamping. However, this has not been validated by prospective clinical trials and observational studies have shown no increase in neonatal sepsis or neonatal intensive care unit admissions in neonates whose mothers received antibiotics before skin incision.…”

Timing of prophylactic antibiotic at cesarean section: a double-blinded, randomized trial

“…5 Several studies since have been published on the timing of prophylactic antibiotic administration for cesarean delivery, but they had mixed results and many of the studies were underpowered. [5][6][7][8][9][10][11][12][13][14] Therefore, the question of the importance of antibiotic timing in cesarean section still remains. Our study evaluates the timing of antibiotic administration in a large community hospital setting.…”