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Does Timely Antibiotic Administration Decrease Hospital Length of Stay in Chorioamnionitis?

Doehrman Pooja D. MD MPH; Erickson, Laurie MD; Adams, Judith MD; Molyneux, Melissa
Obstetrics & Gynecology: May 2014
doi: 10.1097/01.AOG.0000447332.91119.34
Monday, April 28, 2014: PDF Only

INTRODUCTION: The objective of this study was to evaluate the diagnosis to treatment interval in cases of chorioamnionitis and the effect on length of postpartum hospital stay.

METHODS: Mothers who met criteria for the diagnosis of chorioamnionitis (temperature greater than 38°C, maternal heart rate greater than 100 beats per minute, and fetal heart rate greater than 160 beats per minute) were identified. The time interval between first febrile episode and antibiotic administration was correlated with the length of postpartum hospital stay. A sample size of 150 was calculated to provide 80% power to detect a 20% reduction in length of stay.

RESULTS: Of 529 cases of intrapartum fever reviewed, 206 (38.9%) met our definition for chorioamnionitis. Ninety-eight patients received antibiotics after a temperature greater than 38°C. Fifty-eight (59.5%) patients received antibiotics within 1 hour of their first fever. There was a 17% reduction in the length of postpartum hospital admission in the group receiving antibiotics within 1 hour: 2.69 days compared with 3.24 days, respectively (P=.004).

CONCLUSION: Antibiotic administration within the 1 hour of a first fever is associated with a decrease in the length of postpartum hospital admission for patients with chorioamnionitis, and further investigation may reveal a reduction in overall health care costs.

Financial Disclosure: Pooja D. Doehrman, MD, MPH, Laurie Erickson, MD, Judith Adams, MD, and Melissa Molyneux—These authors have no conflicts of interest to disclose relative to the contents of this presentation.

© 2014 by The American College of Obstetricians and Gynecologists.