Re: Prophy ABX for Elective C/S was Re: No Posts!
From: Larry Glazerman (l.glazerman@rcn.com)
Thu Nov 29 18:36:36 2007
I think it's important that we realize we're talking about two
different things here, both with different guidelines:
1. GBS prophylaxis
2. Surgical prophylaxis for cesarean section.
I don't do OB anymore, but I wonder if a gram of Ancef before incision
will prevent GBS sepsis in the newborn. Clearly, those who give the
Ancef after cord clamping won't effect GBS in the neonate.
--
Larry R. Glazerman MD
St. Luke's Center for Advanced Gynecologic Care
250 Cetronia Road Suite 305
Allentown PA 18104
glazerl@slhn.org
On Nov 29, 2007, at 3:12 PM, Andrew Folley wrote:
> Dan
> the problem is that antibiotic prophylaxis is a recommended
> guideline from ACOG sine 2004.
> We use one dose one time of Ancef 2 grams although one is sufficient
> for women less than 200 pounds and procedure less than 1 hour. We
> give it 15 minutes to 1 hour prio to c-section incision.
>
> > Date: Thu, 29 Nov 2007 01:34:55 -0600
> > From: el@lisse.NA
> > To: ob-gyn-l@dns.obgyn.net
> > Subject: Re: Prophy ABX for Elective C/S was Re: No Posts!
> >
> > Unless my memory fails me, this has been discussed ad nauseam here
> > and Cochrane unequivocally states that a one shot intra-operative
> > prophylaxis reduces infection rates, bothe for emergencies (ie C/S)
> > and (supposedly) clean operationes (TAH).
> >
> > And, if I am not mistaken low income (:-)-O) Antibiotics do as well
> > as expensive ones. Our ICU honcho suggested Augmentin and if that's
> > not available (in the Public Hospital) Ampicillin. Works very well
> > for me.
> >
> > el
> >
> > on 11/29/07 3:05 AM R. Daniel Braun said the following:
> > > What is your infection rate on elective sections who don't get
> > > antibiotics? If it is less than 5%, giving prophylactic
> antibiotics is
> > > probably not justified.
> > > In a healthy upper S-E population, and with a surgeon who
> handles tissue
> > > gently and hardly ever takes more than 25 minutes, less than 5%
> > > puerperal morbidity should be expected without antibiotics.
> > >
> > > Dan
> > >
> > > On Nov 28, 2007 5:10 PM, Andrew Folley <agfolley@hotmail.com
> > > <mailto:agfolley@hotmail.com>> wrote:
> > >
> > > No we do not. My understanding is it is not necessary. However we
> > > are doing surgical antibiotic prophylaxis on all c-sections
> elective
> > > and emergency. agf
> > >
> > > <http://www.windowslive.com/connect.html?ocid=TXT_TAGLM_Wave2_newways_112007
> >
> > >
> > > --
> > > R. Daniel Braun, MD FACOG(L) CMT
> > > Professor Emeritus
> > > Dept. of Obstetrics and Gynecology
> > > Indiana U. School of Medicine
> > >
> > > R. Daniel Braun
> > >
> > > "Science without Religion is LAME; Religion without Science is
> BLIND"
> > > Einstein 1941
> >
> > --
> > Dr. Eberhard W. Lisse \ / Obstetrician & Gynaecologist (Saar)
> > el@lisse.NA el108-ARIN / * | Telephone: +264 81 124 6733 (cell)
> > PO Box 8421 \ / Please do NOT email to this address
> > Bachbrecht, Namibia ;____/ if it is DNS related in ANY way
>
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