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Re: Prophy ABX for Elective C/S was Re: No Posts! From: RModugno@aol.com Fri Nov 30 17:21:53 2007 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Efrain Ramirez: "Re: Pyometra" Previous message: Andrew Folley: "Re: GBS" Maybe in reply to: R. Daniel Braun: "Prophy ABX for Elective C/S was Re: No Posts!" Next in thread: DoctorJoe@aol.com: "Re: No Posts!" In a message dated 11/30/2007 12:42:30 P.M. Eastern Standard Time, agfolley@hotmail.com writes: It is two different topics. and no the 1 gram of ancef preop will not protect the baby form GBS GBS prophylaxis needs to be adminiistered 3-4 hrs before birth for levels to be sufficient. However the pharmokinetics of Ancef are such that it reaches the Baby and achieves levels much more quickly ie 1-2 hrs. than does Penicillin or Ampicillin ____________________________________ Date: Thu, 29 Nov 2007 19:37:27 -0600 ____________________________________ From: l.glazerman@rcn.com To: ob-gyn-l@dns.obgyn.net Subject: Re: Prophy ABX for Elective C/S was Re: No Posts! 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_ (mailto: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_ (mailto: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) > > <_mailto: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_ (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_ (mailto: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 Ancef is pretty "low-income' in these parts and the latest Guidelines for Perinatal Care by ACOG/AAP recommends it be given PRIOR to the incision. Robert Modugno MD MBA FACOG Sylva, NC Next message: Efrain Ramirez: "Re: Pyometra" Previous message: Andrew Folley: "Re: GBS" Maybe in reply to: R. Daniel Braun: "Prophy ABX for Elective C/S was Re: No Posts!" Next in thread: DoctorJoe@aol.com: "Re: No Posts!"

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