Continuing investigation of women at high risk for infection following cesarean delivery. Three-dose perioperative antimicrobial therapy

R. T. DePalma, F. G. Cunningham, K. J. Leveno, M. L. Roark

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19 Citations (Scopus)

Abstract

At Parkland Memorial Hospital a group of women at high risk for infection following cesarean delivery was identified. These included nulliparas who underwent cesarean section for cephalopelvic disproportion 6 or more hours following membrane rupture. During the puerperium, uterine infection developed in 85 to 95% of such women, and one third of this high-risk group had associated complications. The authors have previously reported the efficacy of antimicrobial agents given to these women at the time of cesarean section and continued for 4 days. The present prospective study was designed to assess the efficacy of a shorter course of perioperative antimicrobial therapy for these high-risk women. Three doses of antimicrobial agents were given perioperatively to 305 women randomly assigned to 1 of 3 treatment regimens: 115 were given penicillin plus gentamicin, 82 received 2, 1, and 1 g of cefamandole, respectively, and the remaining 108 were given 2, 2, and 2 g of cefamandole, respectively. The incidence of uterine infection in these 305 women was 24% and associated complications were identified in 7% of all women. Based upon a comparison of results with the progenitor study, the authors conclude that 3-dose perioperatively antimicrobial therapy is preferred to 4 days of treatment for women at high risk for infection following cesarean delivery.

Original languageEnglish (US)
Pages (from-to)53-59
Number of pages7
JournalObstetrics and Gynecology
Volume60
Issue number1
StatePublished - 1982

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Infection
Cefamandole
Therapeutics
Anti-Infective Agents
Cesarean Section
Cephalopelvic Disproportion
Gentamicins
Penicillins
Postpartum Period
Rupture
Prospective Studies
Membranes
Incidence

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

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title = "Continuing investigation of women at high risk for infection following cesarean delivery. Three-dose perioperative antimicrobial therapy",
abstract = "At Parkland Memorial Hospital a group of women at high risk for infection following cesarean delivery was identified. These included nulliparas who underwent cesarean section for cephalopelvic disproportion 6 or more hours following membrane rupture. During the puerperium, uterine infection developed in 85 to 95{\%} of such women, and one third of this high-risk group had associated complications. The authors have previously reported the efficacy of antimicrobial agents given to these women at the time of cesarean section and continued for 4 days. The present prospective study was designed to assess the efficacy of a shorter course of perioperative antimicrobial therapy for these high-risk women. Three doses of antimicrobial agents were given perioperatively to 305 women randomly assigned to 1 of 3 treatment regimens: 115 were given penicillin plus gentamicin, 82 received 2, 1, and 1 g of cefamandole, respectively, and the remaining 108 were given 2, 2, and 2 g of cefamandole, respectively. The incidence of uterine infection in these 305 women was 24{\%} and associated complications were identified in 7{\%} of all women. Based upon a comparison of results with the progenitor study, the authors conclude that 3-dose perioperatively antimicrobial therapy is preferred to 4 days of treatment for women at high risk for infection following cesarean delivery.",
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