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. 2020 Jan;301(1):69-73.
doi: 10.1007/s00404-019-05370-y. Epub 2019 Dec 6.

The impact of low-dose versus high-dose antibiotic prophylaxis regimens on surgical site infection rates after cesarean delivery

Mauricio La Rosa  1 , Chasey Omere  2 , Tiffany Redfern  2 , Mahmoud Abdelwahab  2 , Nicholas Spencer  2 , Josephine Villarreal  2 , Gayle Olson  2 , George R Saade  2 , Antonio F Saad  2
Affiliations

The impact of low-dose versus high-dose antibiotic prophylaxis regimens on surgical site infection rates after cesarean delivery

Mauricio La Rosa et al. Arch Gynecol Obstet. 2020 Jan.

Abstract

Objective: The objective of this study was to determine if high-dose antibiotic prophylaxis with cefazolin decreases the risk of surgical site infection (SSI) after a cesarean delivery.

Methods: We performed a retrospective cohort study of women who underwent a cesarean section. Two preoperative antibiotic regimens were compared: low dose versus high dose. The primary outcome was SSI. A sample size of 343 patients per group was calculated for a 50% reduction in risk for SSI.

Results: Seven hundred and thirty women were included with an incidence of SSI of 5%. Women who received the high-dose antibiotic regimen had lower rates of risk factors for SSI. The only exception was skin incision closure with staples. The rate of SSI did not differ between the low-dose and high-dose groups, even after adjusting for confounding variables [aOR 1.78, 95% CI (0.82-3.9)].

Conclusions: Higher doses of antibiotic prophylaxis did not decrease the rates of SSI after cesarean delivery.

Keywords: Antibiotics; Cesarean; Infection; Pregnancy; Prophylaxis; Wound.

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