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Timing of prophylactic antibiotic at cesarean section: a double-blinded, randomized trial

Journal of Perinatology volume 33, pages 759–762 (2013)Cite this article

Subjects

Abstract

Objective:

The purpose was to determine the effect of the timing of prophylactic antibiotics for cesarean section on post-operative infectious complications.

Study Design:

This was a prospective, double-blinded, randomized controlled trial in which patients were randomized to receive cefazolin or clindamycin either before skin incision or after cord clamp. The primary outcome was maternal infectious morbidity at 6 weeks postpartum, a composite infectious outcome, which included endometritis, urinary tract infection, wound infection and pneumonia.

Result:

Data on 896 women were analyzed; 449 randomized to skin incision, 447 to cord clamp. Postpartum infections were seen in a total of 8.4% of patients. Timing of antibiotic administration did not significantly affect any maternal postpartum infection rates or selected neonatal outcomes.

Conclusion:

Our results suggest that, in a largely non-laboring population, the timing of prophylactic antibiotic administration does not impact post-operative infectious complications of the mother. Despite being one of the largest randomized controlled trials to address this question, our study still lacked sufficient power to make definitive conclusions.

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Acknowledgements

This study was supported by the St Vincent Foundation (Grant no. 1-7175-1220701).

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, St Vincent Hospital, Indianapolis, IN, USA

    C Francis, M Mumford & E S Moore

  2. Department of Pediatrics, Division of Neonatology, St Louis University, St Louis, MO, USA

    M L Strand

  3. Department of Obstetrics and Gynecology, Washington University School of Medicine, St Louis, MO, USA

    E A Strand

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  1. C Francis
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  2. M Mumford
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  3. M L Strand
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  4. E S Moore
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Correspondence to E A Strand.

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The authors declare no conflict of interest.

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Francis, C., Mumford, M., Strand, M. et al. Timing of prophylactic antibiotic at cesarean section: a double-blinded, randomized trial. J Perinatol 33, 759–762 (2013). https://doi.org/10.1038/jp.2013.56

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