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The efficacy of ampicillin compared with ceftriaxone on preventing cesarean surgical site infections: an observational prospective cohort study

BACKGROUND: Cesarean surgical site infections (SSIs) can be prevented by proper preoperative antibiotic prophylaxis. Differences in antibiotic selection in clinical practice exist according to obstetricians’ preferences despite clear guidelines on preoperative antibiotic prophylaxis. This study aime...

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Autores principales: Assawapalanggool, Srisuda, Kasatpibal, Nongyao, Sirichotiyakul, Supatra, Arora, Rajin, Suntornlimsiri, Watcharin, Apisarnthanarak, Anucha
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5778626/
https://www.ncbi.nlm.nih.gov/pubmed/29387347
http://dx.doi.org/10.1186/s13756-018-0304-6
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author Assawapalanggool, Srisuda
Kasatpibal, Nongyao
Sirichotiyakul, Supatra
Arora, Rajin
Suntornlimsiri, Watcharin
Apisarnthanarak, Anucha
author_facet Assawapalanggool, Srisuda
Kasatpibal, Nongyao
Sirichotiyakul, Supatra
Arora, Rajin
Suntornlimsiri, Watcharin
Apisarnthanarak, Anucha
author_sort Assawapalanggool, Srisuda
collection PubMed
description BACKGROUND: Cesarean surgical site infections (SSIs) can be prevented by proper preoperative antibiotic prophylaxis. Differences in antibiotic selection in clinical practice exist according to obstetricians’ preferences despite clear guidelines on preoperative antibiotic prophylaxis. This study aimed to compare the efficacy of ampicillin and ceftriaxone in preventing cesarean SSIs. METHODS: The observational prospective cohort study was conducted at a tertiary hospital in Thailand from 1 January 2007 to 31 December 2012. Propensity scores for ceftriaxone prophylaxis were calculated from potential influencing confounders. The cesarean SSI rates of the ceftriaxone group vs. those of the ampicillin prophylactic group were estimated by multilevel mixed-effects Poisson regression nested by propensity score. RESULTS: Data of 4149 cesarean patients were collected. Among these, 911 patients received ceftriaxone whereas 3238 patients received ampicillin as preoperative antibiotic prophylaxis. The incidence of incisional SSIs was (0.1% vs. 1.2%; p = 0.001) and organ space SSIs was (1.2% vs. 2.9%; p = 0.003) in the ceftriaxone group compared with the ampicillin group. After adjusting for confounders, the rate ratios of incisional and organ/space SSIs in the ceftriaxone compared with the ampicillin group did not differ (RR, 0.23; 95% CI 0.03–1.78), and (RR, 1.62; 95% CI 0.83–3.18), respectively. CONCLUSION: These data indicate no difference exists between ampicillin and ceftriaxone to prevent SSIs after cesarean section. Ampicillin may be used as antibiotic prophylaxis in cesarean section. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13756-018-0304-6) contains supplementary material, which is available to authorized users.
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spelling pubmed-57786262018-01-31 The efficacy of ampicillin compared with ceftriaxone on preventing cesarean surgical site infections: an observational prospective cohort study Assawapalanggool, Srisuda Kasatpibal, Nongyao Sirichotiyakul, Supatra Arora, Rajin Suntornlimsiri, Watcharin Apisarnthanarak, Anucha Antimicrob Resist Infect Control Research BACKGROUND: Cesarean surgical site infections (SSIs) can be prevented by proper preoperative antibiotic prophylaxis. Differences in antibiotic selection in clinical practice exist according to obstetricians’ preferences despite clear guidelines on preoperative antibiotic prophylaxis. This study aimed to compare the efficacy of ampicillin and ceftriaxone in preventing cesarean SSIs. METHODS: The observational prospective cohort study was conducted at a tertiary hospital in Thailand from 1 January 2007 to 31 December 2012. Propensity scores for ceftriaxone prophylaxis were calculated from potential influencing confounders. The cesarean SSI rates of the ceftriaxone group vs. those of the ampicillin prophylactic group were estimated by multilevel mixed-effects Poisson regression nested by propensity score. RESULTS: Data of 4149 cesarean patients were collected. Among these, 911 patients received ceftriaxone whereas 3238 patients received ampicillin as preoperative antibiotic prophylaxis. The incidence of incisional SSIs was (0.1% vs. 1.2%; p = 0.001) and organ space SSIs was (1.2% vs. 2.9%; p = 0.003) in the ceftriaxone group compared with the ampicillin group. After adjusting for confounders, the rate ratios of incisional and organ/space SSIs in the ceftriaxone compared with the ampicillin group did not differ (RR, 0.23; 95% CI 0.03–1.78), and (RR, 1.62; 95% CI 0.83–3.18), respectively. CONCLUSION: These data indicate no difference exists between ampicillin and ceftriaxone to prevent SSIs after cesarean section. Ampicillin may be used as antibiotic prophylaxis in cesarean section. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13756-018-0304-6) contains supplementary material, which is available to authorized users. BioMed Central 2018-01-22 /pmc/articles/PMC5778626/ /pubmed/29387347 http://dx.doi.org/10.1186/s13756-018-0304-6 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Assawapalanggool, Srisuda
Kasatpibal, Nongyao
Sirichotiyakul, Supatra
Arora, Rajin
Suntornlimsiri, Watcharin
Apisarnthanarak, Anucha
The efficacy of ampicillin compared with ceftriaxone on preventing cesarean surgical site infections: an observational prospective cohort study
title The efficacy of ampicillin compared with ceftriaxone on preventing cesarean surgical site infections: an observational prospective cohort study
title_full The efficacy of ampicillin compared with ceftriaxone on preventing cesarean surgical site infections: an observational prospective cohort study
title_fullStr The efficacy of ampicillin compared with ceftriaxone on preventing cesarean surgical site infections: an observational prospective cohort study
title_full_unstemmed The efficacy of ampicillin compared with ceftriaxone on preventing cesarean surgical site infections: an observational prospective cohort study
title_short The efficacy of ampicillin compared with ceftriaxone on preventing cesarean surgical site infections: an observational prospective cohort study
title_sort efficacy of ampicillin compared with ceftriaxone on preventing cesarean surgical site infections: an observational prospective cohort study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5778626/
https://www.ncbi.nlm.nih.gov/pubmed/29387347
http://dx.doi.org/10.1186/s13756-018-0304-6
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