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- W2782068290 abstract "To compare postoperative infections among women undergoing non-elective cesarean delivery (CD) who received antibiotic prophylaxis regimens, either standard (cefazolin) vs. alternative (gentamicin and/or clindamycin) antibiotics. Secondary analysis of a randomized controlled trial of adjunctive azithromycin antibiotic prophylaxis at the time of non-elective CD. Women received prophylactic antibiotic regimens, either standard or alternative regimen for concerns about allergy. Our primary outcome was maternal puerperal infection: a composite of endometritis, wound infection (superficial or deep), or other infections (abdominopelvic abscess, maternal sepsis, pelvic septic thrombophlebitis) occurring up to 6 weeks postpartum. Secondary outcomes included individual composite components. Logistic regression models estimated odds of infection complications by antibiotic regimen after adjustment for confounding factors. Confounders were included if they were associated with the exposure and outcome using the change-in-estimate selection approach set at 10% level for inclusion in the final model. We performed a sensitivity analysis by excluding women in the alternative group who received penicillin (PCN) for Group B streptococcus (GBS). Of the 2013 women enrolled, 2007 were included in this analysis; 6 were excluded due to no (5) or unknown (1) antibiotic regimen. Two women in the alternative group received PCN. 1937 (96.5%) received cefazolin and 70 (3.5%) received non-cephalosporin antibiotics. Maternal age, body mass index, skin incision, azithromycin receipt, smoking, GBS colonization and medical comorbidities were similar between the two groups. There was no difference in primary composite between women who received standard versus alternative antibiotics (Table 1). A higher proportion of women receiving alternative antibiotics had a wound infection compared to those who received standard antibiotics (Table 1). Results were similar in the sensitivity analysis. In non-elective CD, alternative prophylactic antibiotics appear inferior to standard regimens for prevention of wound infection. Standard antibiotics (cefazolin) should be included whenever possible for prevention of cesarean wound infections. Prophylactic strategies for cephalosporin allergic/intolerant women should be developed." @default.
- W2782068290 created "2018-01-12" @default.
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- W2782068290 date "2018-01-01" @default.
- W2782068290 modified "2023-10-18" @default.
- W2782068290 title "875: Non-cephalosporin perioperative antibiotic regimen and maternal postoperative infection" @default.
- W2782068290 doi "https://doi.org/10.1016/j.ajog.2017.11.412" @default.
- W2782068290 hasPublicationYear "2018" @default.
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