Re: Prophylactic antibiotics at csection

From: Steve & Eryl Raymond (eryl@intekom.co.za)
Fri Mar 26 13:23:34 2004

Our paediatricians tell us that they don't care one way or the other whether mother had antibiotics or not - they treat a baby with signs or symptoms of infection without reference to the obstetric antibiotics. As far as I can see they don't place much emphasis on swabs or cultures taken at delivery. Because of this all our sections get a gram of cefoxitin BEFORE the incision. Steve

DoctorJoe@aol.com wrote:

> In a message dated 3/25/04 8:39:46 PM, Glen.Elrod@ELMENDORF.af.mil writes:
>
> << The newest ACOG technical bulletin on prophylactic antibiotics in Ob/Gyn
>
> states that prophylactic antibiotics are acceptable for csections.
>
> According to this it is "most commonly given after cord clamp."
>
> Having just sat on a meeting of our infectious disease board reviewing
>
> postoperative infectinos and cs infections specifically, I could not come up
>
> with nor find a rational reason to wait until after cord clamp if the idea
>
> was to prevent surgical infection.
>
> For gyn surgery, most commonly these are given 30 minutes before the case.
>
> Can someone help with a reason for the difference? >>
>
> The original surgical research indicated the best results if antibiotics were
> given before incision. This is obviously the accepted way to do it, even
> today.
>
> In C-secions who are NOT already infected, it should be the same procedure.
> However, over the years the Pediatricians have bitched and complained that a
> baby with antibiotics on board at delivery MUST have a "full" course of
> antibiotics "just in case," since cultures will be "unreliable" due to interference by
> antibiotics. Therefore, giving someone a gram of cefazolin (or whatever)
> before a C-section often doomed a baby to a 10 day course of amp&gent or whatever
> the broad-spectrum coverage du jour was in the nursery.
>
> Soooooo, to get around the (less than scientifically reasonable) actions of
> the pediatricians, we started giving the antibiotics (prophylaxis, not
> treatment) AFTER the cord was clamped, to make sure that the baby didn't get any and
> the pediatricians wouldn't go overboard. That practice has persisted to this
> day.
>
> Interestingly, when a mother gets prophylactic AMPICILLIN (or penicillin) in
> labor for GBS prevention, the pediatricians don't put them on 10 days of
> broad-spectrum coverage. So go figure.
>
> Joe P.
>

use when must restrict search to only the ob-gyn-l forum...
Enter search keywords:
Returns per screen: Require all keywords:

Return to OB-GYN-L Mail a New Message to the Forum: ob-gyn-l@obgyn.net
Forum Administrator: geffrey.klein@obgyn.net
Report Technical Problems: webmaster@obgyn.net
Last Updated: Fri May 2 04:38:08 2008

The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.

home | medical professionals | women | industry | forums | international
e-mail | about us | advertising | our sponsors | contact us | disclaimer |

This information is provided for educational purposes only.
Please read the disclaimer. ©1996-2000, all rights reserved.
Do not reproduce without permission of MediSpecialty.com