Skin preparation type and post-cesarean infection with use of adjunctive azithromycin prophylaxis.

Autor: Ausbeck EB; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology and Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL, USA., Jauk VC; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology and Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL, USA., Boggess KA; Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC, USA., Saade G; The University of Texas Medical Branch, Galveston, TX, USA., Longo S; Department of Obstetrics and Gynecology, Ochsner Health System, New Orleans, LA, USA., Esplin S; The University of Utah, Salt Lake City, UT, USA.; Department of Maternal Fetal Medicine, Intermountain Health Care, Salt Lake City, UT, USA., Cleary K; Department of Obstetrics and Gynecology, Columbia University, New York, NY, USA., Wapner R; Department of Obstetrics and Gynecology, Columbia University, New York, NY, USA., Letson K; Mission Hospital, Asheville, NC, USA., Owens M; Department of Obstetrics and Gynecology, University of Mississippi, Jackson, MS, USA., Blackwell S; Obstetrics, Gynecology and Reproductive Sciences, University of Texas Health Sciences Center, Houston, TX, USA., Ambalavanan N; Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA., Szychowski JM; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology and Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL, USA.; Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA., Andrews W; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology and Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL, USA., Tita ATN; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology and Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL, USA.
Jazyk: angličtina
Zdroj: The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians [J Matern Fetal Neonatal Med] 2022 Jul; Vol. 35 (14), pp. 2690-2694. Date of Electronic Publication: 2020 Jul 29.
DOI: 10.1080/14767058.2020.1797665
Abstrakt: Objective: To compare the frequency of postoperative surgical site infection (SSI) by type of skin preparation used for unscheduled cesarean in the setting of adjunctive azithromycin prophylaxis.
Methods: Secondary analysis of a multi-center randomized controlled trial of adjunctive azithromycin (500 mg intravenous) versus placebo in women who were ≥24 weeks gestation and undergoing unscheduled cesarean (i.e. during labor or ≥4 h after membrane rupture). Type of skin preparation used was identified based on the protocol at the hospital at the time of delivery: iodine-alcohol, chlorhexidine, chlorhexidine-alcohol, or the combination of chlorhexidine-alcohol and iodine. The primary outcome of this analysis was incidence of post-operative SSI, as defined by CDC criteria. Multivariable logistic regression was applied for adjustments.
Results: All 2013 women in the primary trial were included in this analysis. Women were grouped according to type of skin preparation received: iodine-alcohol ( n  = 193), chlorhexidine ( n  = 733), chlorhexidine-alcohol ( n  = 656), and chlorhexidine-alcohol and iodine combined sequentially ( n  = 431). The unadjusted rates of wound infection ranged from 2.9% to 5.7%. Using iodine-alcohol as the referent, the adjusted odds ratios for wound SSI were 0.71 (95% CI 0.30-1.66) for chlorhexidine, 0.97 (95% CI 0.41-2.28) for chlorhexidine-alcohol, and 0.88 (95% CI 0.36-2.20) for chlorhexidine-alcohol with iodine combination.
Conclusion: In women undergoing unscheduled cesarean delivery in a trial of adjunctive azithromycin, the type of skin preparation used did not appear to be associated with the frequency of wound SSI.
Databáze: MEDLINE
Externí odkaz: