Add like
Add dislike
Add to saved papers

Decreasing incidence of postcesarean endometritis with extended-spectrum antibiotic prophylaxis.

OBJECTIVE: To describe the effect of an extended-spectrum prophylactic antibiotic regimen on postcesarean endometritis.

METHODS: This is a cohort study of trends in postcesarean endometritis using data both from prospective surveillance by the infection control unit and from query of our obstetric computerized database to compare three periods of antibiotic prophylaxis: standard narrow-spectrum with intravenous first- or second-generation cephalosporin (1992-1996), clinical trial of extended-spectrum with addition of intravenous doxycycline and oral azithromycin (1997-1999), and routine use of extended-spectrum with addition of intravenous azithromycin (2001-2006) to standard cephalosporin prophylaxis.

RESULTS: A total of 48,913 deliveries at 24 weeks or more of gestation occurred from 1992 to 2006, of which 10,966 (22.4%) were cesarean deliveries. Annual cesarean rates increased from 16% to 27.5%. Trends in the incidence of postcesarean endometritis revealed a biphasic decrease consistent with the phased introduction of extended-spectrum prophylaxis. Incidence (95% confidence interval [CI]) of endometritis by prospective surveillance dropped from 19.9% (95% CI 18.6-21.3%) to 15.4% (95% CI 13.2-17.9%) during the clinical trial period: relative risk (RR) 0.77 (95% CI 0.66-0.91), P=.002; and then to 6.3% (95% CI 5.0-7.9%) during routine use of extended-spectrum prophylaxis: RR 0.41 (95% CI 0.31-0.54), P<.001. Corresponding incidence by database query dropped from 23% (95% CI 21.5-24.4%) to 16% (95% CI 14.4-17.9%): RR 0.69 (95% CI 0.61-0.79), P<.001; and then to 2.1% (95% CI 1.8-2.6%): RR 0.13 (95% CI 0.11-0.16), P<.001. These findings were unchanged after adjusting for potential confounders.

CONCLUSION: Extended-spectrum antibiotic prophylaxis involving the addition of azithromycin to standard narrow-spectrum prophylaxis was associated with a significant reduction in postcesarean endometritis.


Full text links

We have located links that may give you full text access.
Can't access the paper?
Try logging in through your university/institutional subscription. For a smoother one-click institutional access experience, please use our mobile app.

For the best experience, use the Read mobile app

Group 7SearchHeart failure treatmentPapersTopicsCollectionsEffects of Sodium-Glucose Cotransporter 2 Inhibitors for the Treatment of Patients With Heart Failure Importance: Only 1 class of glucose-lowering agents-sodium-glucose cotransporter 2 (SGLT2) inhibitors-has been reported to decrease the risk of cardiovascular events primarily by reducingSeptember 1, 2017: JAMA CardiologyAssociations of albuminuria in patients with chronic heart failure: findings in the ALiskiren Observation of heart Failure Treatment study.CONCLUSIONS: Increased UACR is common in patients with heart failure, including non-diabetics. Urinary albumin creatininineJul, 2011: European Journal of Heart FailureRandomized Controlled TrialEffects of Liraglutide on Clinical Stability Among Patients With Advanced Heart Failure and Reduced Ejection Fraction: A Randomized Clinical Trial.Review

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

Read by QxMD is copyright © 2021 QxMD Software Inc. All rights reserved. By using this service, you agree to our terms of use and privacy policy.

You can now claim free CME credits for this literature searchClaim now

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app