The impact of low-dose versus high-dose antibiotic prophylaxis regimens on surgical site infection rates after cesarean delivery

• DOI: 10.1007/s00404-019-05370-y
• Publication Date: 2019-12-06T12:08:57Z
• Authors: Mauricio La Rosa; Chasey Omere; Tiffany Redfern; Mahmoud Abdelwahab; Nicholas Spencer; Josephine Villarreal; Gayle Olson; George R. Saade; Antonio F. Saad
• Keywords: Cefazolin; Surgical Site Infection; Regimen; Cesarean delivery

The objective of this study was to determine if high-dose antibiotic prophylaxis with cefazolin decreases the risk of surgical site infection (SSI) after a cesarean delivery.We performed a retrospective cohort study of women who underwent a cesarean section. Two preoperative antibiotic regimens were compared: low dose versus high dose. The primary outcome was SSI. A sample size of 343 patients per group was calculated for a 50% reduction in risk for SSI.Seven hundred and thirty women were included with an incidence of SSI of 5%. Women who received the high-dose antibiotic regimen had lower rates of risk factors for SSI. The only exception was skin incision closure with staples. The rate of SSI did not differ between the low-dose and high-dose groups, even after adjusting for confounding variables [aOR 1.78, 95% CI (0.82-3.9)].Higher doses of antibiotic prophylaxis did not decrease the rates of SSI after cesarean delivery.