Antibiotic prophylaxis in cesarean. Hospital Center Pereira Rossell (CHPR)
The needs of protocols
Abstract
Objective: to undertake a situational diagnosis of prophylactic use of antibiotics in cesareans at the Centro Hospitalario Pereira Rossell (CHPR).
Methods: we analyzed the characteristics of prophylaxis antibiotic therapy in hospitalized patients who underwent cesarean in the CHPR from November to December 2001.
Results: one patient of a total of 140 did not receive chemoprophylaxis. Indicated antibiotics were cephazoline 57.5%, ampiciline-sulbactam 33.1% and cephradine 9.4%. Prophylaxis started after surgery in 55.4% cases (mean 5 hours), before surgery in 23.7% and during surgery in 20.9%. Antibiotic therapy lasted 2 days (mean, range 0- 11). There were no differences between patients on urgent surgery and coordinated surgery in relation to antibiotic characteristics.
Conclusions: problems related to antibiotic choice, administration time and prophylaxis duration were identified in cesareans. A protocolization by means of intravenous single-dose cephazoline is suggested. Future studies to assess its application should be done.
References
2) Bancher o P, Vázquez X, De Larrobla M, Giachetto G, Tamosiunas G, Greckzanik A. Uso de antibióticos en un servicio de internación ginecológica. Resultados preliminares. Medicamentos y Salud. Órgano de difusión de GAPURMED (Grupo argentino para el uso racional de los medicamentos) 2001; 4(1,2,3): 8-12.
3) Duff P. Prophylactic antibiotics for cesarean delivery: A simple cost-effective strategy for prevention of postoperative morbidity. Am J Obstet Gynecol 1987; 157: 794-8.
4) Chelmow D, Ruehli MS, Huang E. Prophylactic use of antibiotics for nonlaboring patiens undergoing cesarean delivery with intact membranes: a meta- analysis. Am J Obstet Gynecol 2001; 184(4): 656-61.
5) Mah MW, Pyper AM, Oni GA, Memish ZA. Impact of antibiotic prophylaxis on wound infection after cesarean section in a situation of expected higher risk. Am J Infect Control 2001; 29(2): 85-8.
6) Spinnato JA, Youkilis B, Cook VD, Pietrantoni M, Clark AL, Gall SA. Antibiotic prophylaxis at cesarean delivery. J Matern Fetal Med 2000; 9(6): 348-50.
7) Parto por cesárea e histerectomía poscesárea. In: Cunningham FG, Mac Donald PC, Grant NF, Leveno KJ, Gilstrap LC, Hunkins G, et al. Williams Obstetricia. 20ª ed. Buenos Aires: Panamericana, 1998: 477-97.
8) Savoia MC. Enfermedades bacterianas, micóticas y parasitarias. In: Burrow GN, Duffy TP. Complicaciones Médicas durante el embarazo. 5º ed. Buenos Aires: Panamericana, 2001: 332-4.
9) Huskins WC, Ba-Thike K, Festin MR, Limpongsanurak S, Lumbiganon P, Peedicayil A, et al. An international survey of practice variation in the use of antibiotic prophylaxis in cesarean section. Int J Gynaecol Obstet 2000; 73: 141-5.
10) Dellinger EP, Gross PA, Barret TL, Krause PJ, Martone WJ, Mc Gowan JE, et al. Standard for antimicrobial Prophylaxis in Surgical Procedures. Clin Infect Dis 1994; 18: 422-7.
11) American Society of Health System Pharmacists. Therapeutic Guidelines on Antimicrobial Prophylaxis in Surgery. Am J Health Sist Pharm 1999; 56(18): 1839-88.
12) Hopkins L, Smaill F. Antibiotic prophylaxis regimens and drugs for cesarean section (Cochrane Review). 2002: [1 página]. Obtenido de: URL: http://www.update-software.com/ abstracts/ab001136.htm (consultado 04/01/02).
13) Scottish Intercollegiate Guideline Network (SIGN). Antibiotic Prophylaxis in Surgery (clinical guideline). Jul 2000: [52 páginas]. Obtenido de: URL: http://www.sign.ac.uk/guidelines/fulltext/45/index.html (consultado 13/09/01).
14) Smaill F, Hofmeyr GJ. Antibiotic prophylaxis for cesarean section (Cochrane Review). 2002: [1 página]. Obtenido de: URL: http://www.update-software.com/abstracts/ab000933. htm (consultado 04/01/02).
15) Rouzi AA, Khalifa F, Ba’aqeel HS, Al-Hamdan HS, Bondagji N. The routine use of cefazolin in cesarean section. Int J Gynecol Obstetrics 2000; 69: 107-12.
16) Monte E, Jiménez NV. Aspectos farmacocinéticos y farmacodinámicos de la profilaxis antibiótica en cirugía. Rev OFIL 1997; 7(1):80-6.
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