Obstetric Surgical Site Infections: 2 Grams Compared With 3 Grams of Cefazolin in Morbidly Obese Women

Obstetrics and Gynecology
Homa K AhmadziaJenell S Coleman

Abstract

To estimate whether morbidly obese gravid patients were less likely to develop a surgical site infection after receiving a higher dose of preoperative prophylactic antibiotics. A retrospective cohort study of morbidly obese pregnant women undergoing cesarean delivery was conducted at two tertiary care centers from 2008 to 2013. Exposure was defined as receiving 2 g compared with 3 g cefazolin preoperatively. Disease was defined by diagnosis of a surgical site infection using Centers for Disease Control and Prevention criteria. We estimated a sample size of 141 patients in each group for a 67% reduction (15% to 5%) in risk for a surgical site infection. There were 335 women included in the cohort with a median absolute weight of 310 (interquartile range 299-333) pounds. Forty-four (13.1%) women were diagnosed with a surgical site infection. There was no difference in surgical site infection among those women who received 2 g compared with 3 g cefazolin (13.1% [23/175] compared with 13.1% [21/160]; P=.996). Labor (crude odds ratio [OR] 2.31, 95% confidence interval [CI] 1.21-4.40), internal labor monitoring (OR 2.78, 1.45-5.31), blood loss greater than 1,500 mL (OR 2.15, 1.09-5.78), and staple closure (OR 2.2, 1.15-4.21) were ass...Continue Reading

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Citations

Jan 5, 2017·Journal of Perinatology : Official Journal of the California Perinatal Association·A DuffieldB Carvalho
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