Re: Antibiotics and timing of surgery
From: Dr Eberhard Lisse (el@lisse.NA)
Mon Mar 20 15:23:15 2006
Ef,
It's not the maternal morbidity that is the issue, some Pediatricians
feel that given befoe you clamp the cord might interfere with their
diagnostics later on. Our own Peds who really know what they are doing,
don't care one bit. Neither do I then.
el
on 3/20/06 3:51 PM Efrain Ramirez said the following:
> Timing of prophylactic antibiotic administration in the uninfected
> laboring gravida: a randomized clinical trial.
>
> Thigpen BD, Hood WA, Chauhan S, Bufkin L, Bofill J, Magann E, Morrison
> JC
>
> Am J Obstet Gynecol (2005 Jun) 192(6):1864-8; discussion 1868-71 ISSN:
> 0002-9378
>
> Abstract
>
> OBJECTIVE: The purpose of this prospective study was to determine
> whether the timing of prophylactic antibiotics at cesarean delivery
> influences maternal/neonatal infectious morbidity.
>
> STUDY DESIGN: In this double-blind placebo-controlled trial, cefazolin
> was given at skin incision (group A) or at cord clamping (group B).
> Patients were eligible for the trial if they had labored and required a
> cesarean delivery.
>
> RESULTS: Over
>
> Top of Abstract
>
> a 30-month period 303 patients with singleton pregnancies entered the
> trial; 153-group A, 149-group B. Demographics, indication for cesarean
> delivery (P = .54), and operative time (P = .999), as well as rates of
> endometritis (RR 0.67, 95% CI 0.42-1.07), wound infection (RR 0.84, 95%
> CI 0.45-1.55), neonatal sepis (RR 1.28, 95% CI 0.91-1.79), and NICU
> admissions (RR 1.28, 95% CI 0.91-1.79) were similar between the 2
> groups.
>
> CONCLUSION: There was no difference in maternal infectious morbidity
> whether antibiotics were given before skin incision or at cord clamping.
>
> At Mon, 20 Mar 2006, Elrod, Darryl G MAJ 48 MDOS/SGOBO wrote:
>> We are still giving ancef at cord clamp.
>>
>> Glen
>>
>> //SIGNED//
>>
>> D. Glen Elrod, Maj., USAF, MC
>>
>> Obstetrician/Gynecologist
>>
>> Chief of Obstetrics
>>
>> 48 MDOS/SGOBO
>>
>> RAF Lakenheath, England
>>
>> Telephone DSN: 314-226-8130
>>
>> Comm: +44 (0) 1638 52 8130
>>
>> Notice of Confidentiality
>> Under the Privacy Act of 1974, you must safeguard all information
>> reflected on this e-mail and, if applicable, all attachments.
>> Disclosure of information is IAW AFI 33-119, AFI 33-127, AFI 37-131, AFI
>> 37-132, AFI 33-219, and PL 93-579"
>> This e-mail message including any attachments is for the sole use of the
>> intended recipient(s) and may contain confidential and privileged
>> information. Any unauthorized review, use, disclosure or distribution is
>> prohibited. If you are not the intended recipient, please contact the
>> sender by reply e-mail and destroy all copies of the original message.
>> Any questions pertaining to disclosure should be directed to the privacy
>> officer.
>>
>> -----Original Message-----
>> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of S
>> Osterling M.D.
>> Sent: Friday, March 17, 2006 6:44 PM
>> To: Multiple recipients of list OB-GYN-L
>> Subject: Antibiotics and timing of surgery
>>
>> Many of your gyn ORs are being evaluated for timeliness of antibiotics.
>> The standard is within one hour of the incision.
>>
>> The big exception to this is the c-section. Most of us give 1 gram
>> kefzol at cord clamp. This is done at the request of pediatrics.
>>
>> Is anyone on the list giving the antibiotics prior to incision for
>> "better" prophylaxis?
>>
>> S. Osterling M.D.
>> California
>
> --
> “ The greatest obstacle to knowledge is not ignorance,
> it is the illusion of knowledge.” Daniel J. Boorstin - Historian
