Randomized controlled trial on prevention of postcesarean infection using penicillin and cephalothin in Brazil

Rudge, Marilza Vieira Cunha; Atallah, Álvaro Nagib; Peraçoli, José Carlos; Tristão, Andréa da Rocha; Neto, Moisés Mendonça

doi:10.1080/00016340600697538

Cited by 17 publications

(4 citation statements)

References 10 publications

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“…Studies of costs of antibiotic prophylaxis in cesarean section show conflicting results. While some studies show antibiotic prophylaxis to be cost reducing [10–12] others demonstrate the opposite [13–15]. The majority of the studies consider either emergency cesarean section [13] or a mix of emergency and elective cesarean section [10, 12, 14].…”

Section: Introductionmentioning

confidence: 99%

“…While some studies show antibiotic prophylaxis to be cost reducing [10–12] others demonstrate the opposite [13–15]. The majority of the studies consider either emergency cesarean section [13] or a mix of emergency and elective cesarean section [10, 12, 14]. Only two studies specifically consider costs of antibiotic prophylaxis in elective cesarean section, one from the United States [11] and one from China [15].…”

Section: Introductionmentioning

confidence: 99%

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Cost-effectiveness of antibiotic prophylaxis in elective cesarean section

Jansson

Cao

Nilsson

et al. 2018

Cost Eff Resour Alloc

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BackgroundThe proportion of pregnant women delivered by cesarean section has increased steadily during the past three decades. The risk of infection is 10-fold augmented after elective cesarean section compared to vaginal delivery. Antibiotic prophylaxis may reduce endometritis by 62% and superficial wound infection by 38% after elective cesarean section. International guidelines recommend antibiotic prophylaxis in elective cesarean section, but this procedure is not routinely followed in Sweden. Studies of costs of antibiotic prophylaxis in cesarean section show conflicting results and are based on substantially different incidence of postoperative infections. No study of costs of antibiotic prophylaxis in elective cesarean section in a Swedish or Nordic context has been pursued. The aim of this study was to investigate if antibiotic prophylaxis is cost-reducing in elective cesarean section in Örebro County, Sweden.MethodsAll women undergoing elective cesarean in the Region Örebro County health care system during 2011–2012 were eligible for inclusion. Postoperative infections and risk factors for infections were registered. A hypothetical situation in which all participants had received antibiotic prophylaxis was compared to the actual situation, in which none of them had received antibiotic prophylaxis. The reduction in the risk of postoperative infections resulting from antibiotic prophylaxis was based on a meta-analysis. Costs for in-patient care of postoperative infections were extracted from the accounting system, and costs for out-patient care were calculated according to standard costs. Costs for antibiotic prophylaxis were calculated and compared with the cost reduction that would be implied by the introduction of such prophylaxis.ResultsThe incidences of deep and superficial surgical site infection were 3.5% and 1.3% respectively. Introduction of antibiotic prophylaxis would reduce health care costs by 31 Euro per cesarean section performed (95% credible interval 4–58 Euro). The probability of cost-saving was 99%.ConclusionsAntibiotic prophylaxis in elective cesarean section is cost-reducing in this health care setting. Our results indicate that the introduction of antibiotic prophylaxis in elective cesarean section can also be cost-saving in low infection rate settings.Trial registration Ethical approval was given by the Regional Ethical Review Board in Uppsala (registration number 2013/484).

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness of antibiotic prophylaxis in elective cesarean section

Jansson

Cao

Nilsson

et al. 2018

Cost Eff Resour Alloc

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“…A PubMed search conducted within the last 20 years (2004-2024), using the keywords "prophylactic antibiotics," "surgical site infections," and "emergency surgery," yielded 165 results. Among these, 15 articles were selected because they met the criteria of being clinical trials or randomized controlled trials, while the remaining were excluded because they were reviews [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22].…”

Section: Prophylactic Antibiotics In Emergency Surgerymentioning

confidence: 99%

A Comparative Analysis of Prophylactic Antibiotic Administration in Emergency Surgery Versus Elective Surgery: A Comprehensive Review

Meretsky,

Krumbach,

Schiuma

2024

Cureus

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Surgical site infections (SSIs) contribute to increased patient morbidity, prolonged hospital stays, and substantial healthcare costs. Prophylactic antibiotics play a pivotal role in mitigating the risk of SSIs, with their administration being a standard practice before both emergency and elective surgeries. This paper provides a comprehensive review and comparative analysis of the benefits of prophylactic antibiotic administration in emergency surgery versus elective surgery. Through a systematic literature review and analysis of relevant studies identified through PubMed searches, this paper highlights the specific benefits of prophylactic antibiotics between emergency and elective surgeries. The findings underscore the importance of tailored antibiotic regimens and administration protocols to optimize patient care and promote successful surgical outcomes in diverse clinical settings. Further research is warranted to refine guidelines and enhance understanding of the relationship between prophylactic antibiotics and surgical outcomes across different surgical contexts.

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“…The selected patients were randomly divided into 2 groups: Group A (n = 20), which received 2 g of Cephalotin (1st generation cephalosporin, Keflin ® , ABL antibiotics do Brasil Ltd., Cosmópolis, Brazil) [45,46] during anesthetic induction, and Group B (n = 20) where no antibiotics were administered until bile collection.…”

Section: Experimental Design and Operative Proceduresmentioning

confidence: 99%

Incidence of Bacteriobilia and the Correlation with Antibioticoprophylaxis in Low-Risk Patients Submitted to Elective Videolaparoscopic Cholecystectomy: A Randomized Clinical Trial

Pagani,

Dolfini,

Trazzi

et al. 2023

Antibiotics

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Cholelithiasis has a major impact on global health and affects an average of 20% of the Western population. The main risk factors are females, age over 40 years, obesity and pregnancy. Most of the time it is asymptomatic, but when there are symptoms, they are generally nonspecific. Bile was considered sterile, but today it is known that it contains a complex bacterial flora, which causes biofilm in the gallbladder and gallstones. Among the main bacteria associated with cholelithiasis are Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, species of Enterococcus spp. and Acinetobacter spp. Antibiotic prophylaxis is used in an attempt to reduce postoperative infections, especially at the surgical site. However, some authors found no relationship between the use of antibiotic prophylaxis and a lower risk of surgical site infection. Thus, the aim of this double-blind randomized clinical trial was to compare the existence or not of bacteriobilia in patients at low anesthetic risk who underwent videolaparoscopic cholecystectomy, and its correlation with the use of prophylactic antibiotics. This study included 40 patients between 18 and 65 years old, diagnosed with cholelithiasis, symptomatic or not, with low anesthetic risk classified by the American Society of Anesthesiology in ASA I or ASA II, without complications or previous manipulation of the bile duct, who underwent elective video cholecystectomy, divided into two groups: Experimental Group A (n = 20), which received 2 g of Cephalotin (first-generation Cephalosporin, Keflin®, ABL antibiotics, Cosmópolis, Brazil) during anesthetic induction, and Control Group B (n = 20), where no antibiotics were administered until bile collection. After the procedure, a bile sample was collected and culture and antibiogram were performed. In the sample, 22 (55%) were classified as ASA I and 18 (45%) as ASA II. It was observed that 81.8% of the patients who had a positive culture did not use antibiotics, against 18.2% of those who used prophylaxis. When comparing patients regarding anesthetic risk, ASA I patients had a positive culture in 9.1% of cases, against 90.9% in patients classified as ASA II. It was concluded that patients with higher anesthetic risk (ASA II) have a higher chance of bacteriobilia and benefit from antibiotic prophylaxis when compared to patients with lower anesthetic risk (ASA I).

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Randomized controlled trial on prevention of postcesarean infection using penicillin and cephalothin in Brazil

Cited by 17 publications

References 10 publications

Cost-effectiveness of antibiotic prophylaxis in elective cesarean section

Cost-effectiveness of antibiotic prophylaxis in elective cesarean section

A Comparative Analysis of Prophylactic Antibiotic Administration in Emergency Surgery Versus Elective Surgery: A Comprehensive Review

Incidence of Bacteriobilia and the Correlation with Antibioticoprophylaxis in Low-Risk Patients Submitted to Elective Videolaparoscopic Cholecystectomy: A Randomized Clinical Trial

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