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Perioperative Antibiotic Choice in Labored versus Unlabored Cesareans and Risk of Postcesarean Infectious Morbidity.

Publication ,  Journal Article
Hopkins, MK; Dotters-Katz, S; Boggess, K; Heine, RP; Smid, M
Published in: Am J Perinatol
January 2018

OBJECTIVE:  This study aims to estimate postcesarean infectious morbidity in women receiving perioperative β-lactam versus non-β-lactam antibiotics. METHODS:  We conducted a retrospective cohort analysis of the Maternal-Fetal Medicine Unit Cesarean Registry. The exposure was β-lactam perioperative antibiotics versus non-β-lactam regimens at cesarean delivery (CD). We stratified by labored versus unlabored CD. The primary composite outcome included wound infection, seroma, hematoma, endometritis, readmission due to wound complication, or debridement. Multivariable logistic regression estimated odds of wound complication by antibiotic regimen after adjusting for relevant confounders. RESULTS:  Our analysis included 43,735 women who delivered via CD, 48% following labor. In both groups, 95% of women received β-lactam antibiotics. In the labored CD group (n = 20,860), there was no significant difference in primary outcome by β-lactam versus non-β-lactam antibiotics (10.5 vs. 9.9%, p = 0.53). In the unlabored CD group (n = 22,875), women receiving non-β-lactam antibiotics were more likely to experience a wound complication compared with those in the β-lactam group (6.2 vs. 4.7%, p = 0.02, adjusted odds ratio: 1.39, 95% confidence interval: 1.08-1.80) after adjustment for clinical confounders. CONCLUSION:  In unlabored CD, non-β-lactam antibiotics have a higher risk of wound complications compared with β-lactam regimens. Further study to optimize antibiotic prophylaxis for β-lactam allergic women undergoing unlabored CD is warranted.

Duke Scholars

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Published In

Am J Perinatol

DOI

EISSN

1098-8785

Publication Date

January 2018

Volume

35

Issue

2

Start / End Page

127 / 133

Location

United States

Related Subject Headings

  • Young Adult
  • Trial of Labor
  • Surgical Wound Infection
  • Risk
  • Retrospective Studies
  • Pregnancy
  • Postoperative Complications
  • Perioperative Care
  • Obstetrics & Reproductive Medicine
  • North Carolina
 

Citation

APA
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Hopkins, M. K., Dotters-Katz, S., Boggess, K., Heine, R. P., & Smid, M. (2018). Perioperative Antibiotic Choice in Labored versus Unlabored Cesareans and Risk of Postcesarean Infectious Morbidity. Am J Perinatol, 35(2), 127–133. https://doi.org/10.1055/s-0037-1606187
Hopkins, Maeve K., Sarah Dotters-Katz, Kim Boggess, R Phillips Heine, and Marcela Smid. “Perioperative Antibiotic Choice in Labored versus Unlabored Cesareans and Risk of Postcesarean Infectious Morbidity.Am J Perinatol 35, no. 2 (January 2018): 127–33. https://doi.org/10.1055/s-0037-1606187.
Hopkins MK, Dotters-Katz S, Boggess K, Heine RP, Smid M. Perioperative Antibiotic Choice in Labored versus Unlabored Cesareans and Risk of Postcesarean Infectious Morbidity. Am J Perinatol. 2018 Jan;35(2):127–33.
Hopkins, Maeve K., et al. “Perioperative Antibiotic Choice in Labored versus Unlabored Cesareans and Risk of Postcesarean Infectious Morbidity.Am J Perinatol, vol. 35, no. 2, Jan. 2018, pp. 127–33. Pubmed, doi:10.1055/s-0037-1606187.
Hopkins MK, Dotters-Katz S, Boggess K, Heine RP, Smid M. Perioperative Antibiotic Choice in Labored versus Unlabored Cesareans and Risk of Postcesarean Infectious Morbidity. Am J Perinatol. 2018 Jan;35(2):127–133.
Journal cover image

Published In

Am J Perinatol

DOI

EISSN

1098-8785

Publication Date

January 2018

Volume

35

Issue

2

Start / End Page

127 / 133

Location

United States

Related Subject Headings

  • Young Adult
  • Trial of Labor
  • Surgical Wound Infection
  • Risk
  • Retrospective Studies
  • Pregnancy
  • Postoperative Complications
  • Perioperative Care
  • Obstetrics & Reproductive Medicine
  • North Carolina