Effect of Post– #Cesarean Delivery Oral Cephalexin and Metronidazole on Surgical Site Infection Among #Obese Women
A Randomized Clinical Trial
http://jamanetwork.com/journals/jama/article-abstract/2654382
The rate of obesity among US women has been increasing, and obesity is associated with increased risk of surgical site infection (SSI) following cesarean delivery. The optimal perioperative antibiotic prophylactic regimen in this high-risk population undergoing cesarean delivery is unknown
Participants were randomly assigned to receive oral cephalexin, 500 mg, and metronidazole, 500 mg (n = 202 participants), vs identical-appearing placebo (n = 201 participants) every 8 hours for a total of 48 hours following cesarean delivery Among 403 randomized participants who were included (mean age, 28 SD, 6 years; mean BMI, 39.7 SD, 7.8), 382 (94.6%) completed the trial. The overall rate of SSI was 10.9% (95% CI, 7.9%-14.0%). Surgical site infection was diagnosed in 13 women (6.4%) in the cephalexin-metronidazole group vs 31 women (15.4%) in the placebo group (difference, 9.0% 95% CI, 2.9%-15.0%; relative risk, 0.41 95% CI, 0.22-0.77; P = .01). There were no serious adverse events, including allergic reaction, reported in either the antibiotic group or the placebo group.
Conclusions and Relevance Among obese women undergoing cesarean delivery who received the standard preoperative cephalosporin prophylaxis, a postoperative 48-hour course of oral cephalexin and metronidazole, compared with placebo, reduced the rate of SSI within 30 days after delivery. For prevention of SSI among obese women after cesarean delivery, prophylactic oral cephalexin and metronidazole may be warranted
A Randomized Clinical Trial
http://jamanetwork.com/journals/jama/article-abstract/2654382
The rate of obesity among US women has been increasing, and obesity is associated with increased risk of surgical site infection (SSI) following cesarean delivery. The optimal perioperative antibiotic prophylactic regimen in this high-risk population undergoing cesarean delivery is unknown
Participants were randomly assigned to receive oral cephalexin, 500 mg, and metronidazole, 500 mg (n = 202 participants), vs identical-appearing placebo (n = 201 participants) every 8 hours for a total of 48 hours following cesarean delivery Among 403 randomized participants who were included (mean age, 28 SD, 6 years; mean BMI, 39.7 SD, 7.8), 382 (94.6%) completed the trial. The overall rate of SSI was 10.9% (95% CI, 7.9%-14.0%). Surgical site infection was diagnosed in 13 women (6.4%) in the cephalexin-metronidazole group vs 31 women (15.4%) in the placebo group (difference, 9.0% 95% CI, 2.9%-15.0%; relative risk, 0.41 95% CI, 0.22-0.77; P = .01). There were no serious adverse events, including allergic reaction, reported in either the antibiotic group or the placebo group.
Conclusions and Relevance Among obese women undergoing cesarean delivery who received the standard preoperative cephalosporin prophylaxis, a postoperative 48-hour course of oral cephalexin and metronidazole, compared with placebo, reduced the rate of SSI within 30 days after delivery. For prevention of SSI among obese women after cesarean delivery, prophylactic oral cephalexin and metronidazole may be warranted
Jamanetwork
Effect of Postcesarean Cephalexin-Metronidazole on SSI in Obese Women
This randomized trial compares the effects of postoperative oral cephalexin-metronidazole vs placebo on frequency of surgical site infection (SSI) in obese women undergoing cesarean delivery.