Effectiveness of antimicrobial prophylaxis at 30 versus 60\xa0min before cesarean delivery

Eyal Rom,Malak Wattad,Hadas Rubin,Natanel Levy,Khadeje Seh,Ayellet Jehassi,Raed Salim,Shabtai Romano

doi:10.1038/s41598-021-87846-z

Abstract

This study aimed to examine the effect of antibiotic prophylaxis (AP) given within 30 compared to 30–60 min before skin incision on the incidence of infectious morbidity after cesarean delivery (CD). A retrospective cohort study was conducted at a single institution on data between 2014 and 2018. Women who delivered by CD were divided into two groups according to AP timing before skin incision: group 1 within 30 min, and group 2 from 30 to 60 min. The primary outcome was the incidence of any infectious morbidity. Overall, 2989 women were eligible: 2791 in group 1 and 198 in group 2. The primary composite outcome occurred in 125 women (4.48%) in group 1 and 8 women (4.04%) in group 2 (OR, 1.11; 95% CI 0.54–2.31; P = 0.77). The rate of surgical site infection only, was 1.08% in group 1 and 0.51% in group 2 (OR, 2.13; 95% CI 0.29–15.70; P = 0.72). The incidence was comparable between the groups in a separate sub-analysis restricted to laboring CDs and obese women. The rate of infectious morbidity was similar among women who received AP within 30 min and from 30 to 60 min before skin incision.

Highlights

This study aimed to examine the effect of antibiotic prophylaxis (AP) given within 30 compared to 30–60 min before skin incision on the incidence of infectious morbidity after cesarean delivery (CD)
The primary composite outcome occurred in 125 women (4.48%) who received antibiotic prophylaxis within 30 min before surgical incision and in 8 (4.04%) who received antibiotic prophylaxis 30–60 min before surgical incision
The results showed that for every 1 min increase between antibiotic administration and skin incision, the incidence of the primary outcome decreased by a factor of 1.02; there was a significant increase in the AUC to 0.62

Summary

Introduction

This study aimed to examine the effect of antibiotic prophylaxis (AP) given within 30 compared to 30–60 min before skin incision on the incidence of infectious morbidity after cesarean delivery (CD). The rate of infectious morbidity was similar among women who received AP within 30 min and from 30 to 60 min before skin incision. A number of meta-analysis concluded that antibiotic administration up to 60 min before skin incision, compared to after cord clamping, reduces the infection rate significantly[10,11,12]. Likewise, administering antibiotic prophylaxis more than 1 h before incision in CDs was associated with double the rate of SSI compared to 1 h before incision[13]. The present study aimed to examine the effect of antibiotic prophylaxis timing (up to 30 min vs 30–60 min before surgery) on the rate of infectious morbidity

Objectives

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Results

Conclusion