The use of prophylactic antibiotics in patients undergoing emergency primary cesarean section

Wallace, Roger L.; Yonekura, Masahiro

doi:10.1016/0002-9378(83)90011-x

Cited by 19 publications

(5 citation statements)

References 12 publications

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“…However, careful attention to good surgical technique and postoperative care, together with transfusion facilities, have reduced the hazards of haemorrhage and thromboembolism. Of the many factors which may modify the risk of infection, the most important appears to be the use of prophylactic antibiotics (7,8). The potential risk of aspiration during general anaesthesia is, to a large extent, overcome by the increasing use of epidural block.…”

Section: Discussionmentioning

confidence: 99%

How Safe is Caesarean Section in Current Practice? A Survey of Mortality and Serious Morbility

Broe

Khoo

1989

Aust NZ J Obst Gynaeco

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To assess the safety of Caesarean section in a tertiary referral hospital, a survey was made of maternal deaths associated with the operation in 40,958 total births during the recent 6 years (1982-1987) and serious morbidity in 1,959 consecutive operations over a recent 15-month interval (1986-1987) at the Royal Women's Hospital, Brisbane. There were only 2 deaths in 9,584 Caesarean sections, giving a maternal mortality rate of 20.8 per 100,000 operations and a risk ratio of 3.2 when compared with vaginal delivery. As both deaths were caused by amniotic fluid embolism, they were not considered to be directly attributable to the operation. Serious morbidity, as measured by operative complications, thromboembolism, need for blood transfusion, admission to the intensive care unit, and return of the patient to the operating theatre, was uncommon. The most common morbidity was postoperative pyrexia (representing infection) in 7.7% of operations; this was found to be more frequent in patients under 35 years, those in the public section and those requiring general anaesthesia.

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Section: Discussionmentioning

confidence: 99%

How Safe is Caesarean Section in Current Practice? A Survey of Mortality and Serious Morbility

Broe

Khoo

1989

Aust NZ J Obst Gynaeco

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“…Antibiotic prophylaxis for women undergoing CD has been proven to be beneficial in decreasing postpartum infectious morbidity both in high-risk (in labor post-membrane rupture) [61] or low-risk patients (non-laboring with intact membranes) [62,63]. In a systematic review of over 80 studies on the use of prophylactic antibiotics for CD, the Cochrane Collaboration specifically examined the effect of prophylactic antibiotics on the rate of maternal postpartum fever, wound infection, endometritis, urinary tract infection, serious infectious morbidity/death, as well as maternal side-effects and length of hospital stay [64].…”

Section: Obstetrical Antibiotic Indications During Pregnancymentioning

confidence: 99%

Antibiotic Use and Misuse during Pregnancy and Delivery: Benefits and Risks

Tejada

2014

IJERPH

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Although pregnancy is considered as a physiological state, most pregnant women in developed countries receive multiple medications to prevent maternal or neonatal complications, with antibiotics among the most frequently prescribed. During pregnancy, antibiotics are often prescribed in the context of preterm labor, intrapartum fever, prevention of neonatal Group B Streptococcus fever, and cesarean section. Outside this period, they are commonly prescribed in the community setting for respiratory, urinary, and ear, nose and throat infection symptoms. Whereas some of the current indications have insightful reasons to justify their use, potential risks related to overuse and misuse may surpass the benefits. Of note, the recent 2014 World Health Assembly expressed serious concern regarding antibiotic resistance due to antibiotic overuse and misuse and urged immediate action to combat antibiotic resistance on a global scale. Most studies in the obstetrics field have focused on the benefits of antibiotics for short-term maternal and neonatal complications, but with very little (if any) interest in long-term consequences.

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“…Risk factors associated with postop erative cesarean section morbidity have been suggested by many authors and they include types of anesthesia [10,11], ane mia [11], internal fetal monitoring [12,13], obesity [10,14] and onset of labor [3,8,[14][15][16]. The onset of labor and consequent vaginal examinations expose the patient to a greater risk of infection [7,17,18] and we did show in a previous study [5] that this is a unique risk factor for postopera tive morbidity.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of postoperative morbidity in emergency cesarean section has been reported to be between 25 and 85% [5,[7][8][9], In a previous study [5] we showed the efficacy of a 3-dose perioperative prophylaxis of mez locillin in reducing the postoperative mor bidity in nonelective cesarean section from 70% in a placebo group to 19% in the treated group. In this study, we attempted to define the minimum effective duration of mezlocillin prophylaxis in nonelective cesarean section comparing a single pre operative 5-gram dose mezlocillin with a 3-dose perioperative course, each of 2 g, in a randomized, prospective placebo-controlled fashion.…”

Section: Introductionmentioning

confidence: 99%

Single-versus Multiple-Dose Mezlocillin Prophylaxis in Emergency Cesarean Section

Jaffe¹,

Altaras²,

R³

et al. 1986

Chemotherapy

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163 patients undergoing emergency cesarean section were prospectively and randomized evaluated to determine the effect of mezlocillin in reducing postoperative morbidity. We compared a single 5-gram preoperative dose and a perioperative 3-dose regimen, each of 2 g, with a placebo. Postoperative morbidity was reduced from 65% in the placebo group to 20% in the groups receiving mezlocillin (p < 0.005). The incidences of febrile morbidity, endometritis and urinary tract infection were all significantly lower in both groups given mezlocillin. There was no difference in the reduction of morbidity between the two groups receiving mezlocillin. The main advantages of the prophylaxis included a shorter hospitalization and the absence of serious infections in the treated groups.

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The use of prophylactic antibiotics in patients undergoing emergency primary cesarean section

Cited by 19 publications

References 12 publications

How Safe is Caesarean Section in Current Practice? A Survey of Mortality and Serious Morbility

How Safe is Caesarean Section in Current Practice? A Survey of Mortality and Serious Morbility

Antibiotic Use and Misuse during Pregnancy and Delivery: Benefits and Risks

Single-versus Multiple-Dose Mezlocillin Prophylaxis in Emergency Cesarean Section

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