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Timing of Antimicrobial Prophylaxis Examined for C-Section

TUESDAY, Dec. 29, 2020 -- For women undergoing cesarean section, the risk for surgical site infection (SSI) is not increased when surgical antimicrobial prophylaxis (SAP) is administered after umbilical cord clamping rather than before incision, according to a study published online Dec. 22 in Antimicrobial Resistance & Infection Control.

Rami Sommerstein, M.D., from Bern University Hospital in Switzerland, and colleagues conducted a cohort study involving 55,901 patients from 75 participating Swiss hospitals from 2009 to 2018. The association between SAP administration relative to incision and clamping and the SSI rate was examined.

The researchers found that in 47.2 and 52.8 percent of patients, SAP was administered before incision and after clamping, respectively. No difference was observed in the rate of SSI for those receiving SAP before incision versus after clamping (1.6 versus 1.7 percent, respectively; P = 0.759). The investigators observed no significant association between SAP administration after clamping versus before incision and increased SSI rate (adjusted odds ratio, 1.14; 95 percent confidence interval, 0.96 to 1.36; P = 0.144).

"These results challenge the latest World Health Organization recommendation which extends the time window of SAP from 60 minutes to 120 minutes prior to incision but does not consider administration after clamping," the authors write.

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Posted: December 2020

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