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CC BY-NC-ND 4.0 · AJP Rep 2019; 09(02): e167-e171
DOI: 10.1055/s-0039-1685503
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Efficacy of Non-Beta-lactam Antibiotics for Prevention of Cesarean Delivery Surgical Site Infections

Benjamin S. Harris
1   Department of Obstetrics and Gynecology, Duke University Health System, Durham, North Carolina
,
Maeve K. Hopkins
1   Department of Obstetrics and Gynecology, Duke University Health System, Durham, North Carolina
,
Margaret S. Villers
2   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Duke University Health System, Durham, North Carolina
,
Jeremy M. Weber
3   Department of Biostatistics and Bioinformatics, Duke University Health System, Durham, North Carolina
,
Carl Pieper
3   Department of Biostatistics and Bioinformatics, Duke University Health System, Durham, North Carolina
,
Chad A. Grotegut
2   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Duke University Health System, Durham, North Carolina
,
Geeta K. Swamy
2   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Duke University Health System, Durham, North Carolina
,
Brenna L. Hughes
2   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Duke University Health System, Durham, North Carolina
,
R Phillips Heine
2   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Duke University Health System, Durham, North Carolina
› Author Affiliations Financial The Duke BERD Methods Core's support of this project was made possible (in part) by Grant Number UL1TR002553 from the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of NCATS or NIH.
Further Information

Publication History

02 December 2018

08 March 2019

Publication Date:
30 April 2019 (online)

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Abstract

Objective To examine the association between perioperative Beta (β))-lactam versus non-β-lactam antibiotics and cesarean delivery surgical site infection (SSI).

Study Design Retrospective cohort of women undergoing cesarean delivery from January 1 to December 31, 2014. All women undergoing cesarean after 34 weeks with a postpartum visit were included. Prevalence of SSI was compared between women receiving β-lactam versus non-β-lactam antibiotics. Bivariate analyses were performed using Pearson's Chi-square, Fisher's exact, or Wilcoxon's rank-sum tests. Logistic regression models were fit controlling for possible confounders.

Results Of the 929 women included, 826 (89%) received β-lactam prophylaxis and 103 (11%) received a non-β-lactam. Among the 893 women who reported a non-type I (low risk) allergy, 819 (92%) received β-lactam prophylaxis. SSI occurred in 7% of women who received β-lactam antibiotics versus 15% of women who received a non-β-lactam (p = 0.004). β-Lactam prophylaxis was associated with lower odds of SSI compared with non-β-lactam antibiotics (odds ratio [OR] = 0.43; 95% confidence interval [CI] = 0.22–0.83; p = 0.01) after controlling for chorioamnionitis in labor, postlabor cesarean, endometritis, tobacco use, and body mass index (BMI).

Conclusion β-Lactam perioperative prophylaxis is associated with lower odds of a cesarean delivery surgical site infection compared with non-β-lactam antibiotics.

Keywords

antibiotics - penicillin allergy - cesarean delivery - surgical site infection

Paper Presentation

This paper was presented at Infectious Diseases Society of Obstetrics and Gynecology, Deer Valley, UT, August 10, 2017.


 

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