Adherence to recommendations for antibiotic prophylaxis before cesarean section: a survey of anesthesiologists in Vinnytsia region

Abstract

Annotation. Surgical wound infection is the most common complication after a caesarean section. The frequency of this complication is 3-15%, and it causes maternal mortality in 3% of cases. The work aims to analyze the compliance of the appointment of antibiotic prophylaxis by anesthesiologists in the Vinnytsia region according to the current protocols for women who give birth by caesarean section. We conducted a multicenter regional survey among 21 medical institutions with the participation of 69 anesthesiologists who provide care to obstetric patients in Vinnytsia and Vinnytsia region. In addition to general information on the number of inpatient/ward deliveries, the number of cesarean births, and the urgency of surgery, the e-questionnaire included questions about the choice of antibiotic prophylaxis drug (s) for women who give birth by caesarean section and timing of its conduction. The obtained results reflect the practice of 21/23 (91.3%) obstetric hospitals and departments in the city of Vinnytsia and Vinnytsia region. The results of our study show that most often respondents carry out antibiotic prophylaxis with ceftriaxone 27/67 (40.3%), ampicillin and cefazolin – 18/67 (26.9%). Data analysis was performed using the statistical package “SPSS 20” (SPSS Inc.) version 21.0.0 for Windows. To find the differences in frequencies, we used the method of determining χ2 (Pearson), determined the odds ratio (Odds Ratio) and relative risk (Relative Risk). It was found out that among anesthesiologists who provide care to obstetric patients, 59.7% prescribe antimicrobials in accordance with current guidelines, 64.1% follow the recommended timing of antibiotic prophylaxis - 30-60 minutes before the skin incision, and 2.4% of respondents do not prescribe prophylactic administration of antibiotics for women who give birth by caesarean section. The prospect of further research is the development and implementation of a clear unified strategy for the prevention of infection of the surgical wound in Vinnytsia and Vinnytsia region.