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Effect of Post-cesarean Delivery Oral Cephalexin and Metronidazole on Surgical Site Infection Among Obese Women: A Randomized Clinical Trial

Valent, A.M.; DeArmond, C.; Houston, J.M.; Reddy, S.; Masters, H.R.; Gold, A.; Boldt, M.; DeFranco, E.; Evans, A.T.; Warshak, C.R.

doi: 10.1097/01.aoa.0000542370.40319.d0
Mother, Fetus, Neonate

(JAMA 2017;318(11):1026–1034)

Previous studies estimated 3% to 12% of all cesarean deliveries in the United States are complicated by surgical site infection (SSI). This risk increases as maternal weight increases, and despite preoperative antibiotic regimens, obesity is an independent risk factor for SSI. While standard care has been the use of preoperative cephalosporin antibiotics, other antibiotic combinations have been studied. However, conflicting benefits have been found and none of these studies focused specifically on obese women. In this study, the effects of an additional 48-hour course of postoperative prophylactic oral cephalexin plus metronidazole was compared with the current standard of care (preoperative intravenous cephalosporin alone) in obese women who delivered via cesarean section.

Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR

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