Timing of perioperative antibiotics for cesarean delivery: a metaanalysis. Export

@article{citeulike:3338477, abstract = {OBJECTIVE: The purpose of this study was to summarize the available evidence on timing of perioperative antibiotics for cesarean delivery. STUDY DESIGN: We searched the literature for studies that compare prophylactic antibiotics for cesarean delivery that are given before the procedure vs at cord clamping. Only randomized controlled trials were included. RESULTS: Preoperative administration significantly reduced the risk of postpartum endometritis (relative risk [RR], 0.47; 95\% CI, 0.26-0.85; P = .012) and total infectious morbidity (RR, 0.50; 95\% CI, 0.33-0.78; P = .002). There was a trend toward lower risk of wound infection (RR, 0.60; 95\% CI, 0.30-1.21; P = .15). Preoperative administration of antibiotics did not significantly affect suspected neonatal sepsis that requires a workup (RR, 1; 95\% CI, 0.70-1.42), proven sepsis (RR, 0.93; 95\% CI, 0.45-1.96), or neonatal intensive care unit admissions (RR, 1.07 95\% CI, 0.51-2.24). There was no significant heterogeneity between the randomized controlled trials. CONCLUSION: There is strong evidence that antibiotic prophylaxis for cesarean delivery that is given before skin incision, rather than after cord clamping, decreases the incidence of postpartum endometritis and total infectious morbidities, without affecting neonatal outcomes.}, address = {Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX 77555-0587, USA.}, author = {Costantine, M. M. and Rahman, M. and Ghulmiyah, L. and Byers, B. D. and Longo, M. and Wen, T. and Hankins, G. D. and Saade, G. R.}, citeulike-article-id = {3338477}, citeulike-linkout-0 = {http://dx.doi.org/10.1016/j.ajog.2008.06.077}, citeulike-linkout-1 = {http://view.ncbi.nlm.nih.gov/pubmed/18771991}, citeulike-linkout-2 = {http://www.hubmed.org/display.cgi?uids=18771991}, doi = {10.1016/j.ajog.2008.06.077}, issn = {1097-6868}, journal = {American journal of obstetrics and gynecology}, keywords = {gyne, gynecology}, month = {September}, number = {3}, posted-at = {2008-09-26 02:25:30}, priority = {2}, title = {Timing of perioperative antibiotics for cesarean delivery: a metaanalysis.}, url = {http://dx.doi.org/10.1016/j.ajog.2008.06.077}, volume = {199}, year = {2008} }

TY - JOUR ID - citeulike:3338477 L3 - citeulike-article-id:3338477 N2 - OBJECTIVE: The purpose of this study was to summarize the available evidence on timing of perioperative antibiotics for cesarean delivery. STUDY DESIGN: We searched the literature for studies that compare prophylactic antibiotics for cesarean delivery that are given before the procedure vs at cord clamping. Only randomized controlled trials were included. RESULTS: Preoperative administration significantly reduced the risk of postpartum endometritis (relative risk [RR], 0.47; 95% CI, 0.26-0.85; P = .012) and total infectious morbidity (RR, 0.50; 95% CI, 0.33-0.78; P = .002). There was a trend toward lower risk of wound infection (RR, 0.60; 95% CI, 0.30-1.21; P = .15). Preoperative administration of antibiotics did not significantly affect suspected neonatal sepsis that requires a workup (RR, 1; 95% CI, 0.70-1.42), proven sepsis (RR, 0.93; 95% CI, 0.45-1.96), or neonatal intensive care unit admissions (RR, 1.07 95% CI, 0.51-2.24). There was no significant heterogeneity between the randomized controlled trials. CONCLUSION: There is strong evidence that antibiotic prophylaxis for cesarean delivery that is given before skin incision, rather than after cord clamping, decreases the incidence of postpartum endometritis and total infectious morbidities, without affecting neonatal outcomes. IS - 3 JF - American journal of obstetrics and gynecology SN - 1097-6868 AD - Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX 77555-0587, USA. TI - Timing of perioperative antibiotics for cesarean delivery: a metaanalysis. VL - 199 KW - gyne KW - gynecology AU - Costantine, MM AU - Rahman, M AU - Ghulmiyah, L AU - Byers, BD AU - Longo, M AU - Wen, T AU - Hankins, GD AU - Saade, GR PY - 2008/09// UR - http://dx.doi.org/10.1016/j.ajog.2008.06.077 ER -