Related Experiment Video
Updated: Feb 5, 2026
Surgical Method for Virally Mediated Gene Delivery to the Mouse Inner Ear through the Round Window Membrane
Published on: March 16, 2015
Choice of Prophylactic Antibiotics and Surgical Site Infections After Cesarean Delivery
Tetsuya Kawakita1, Chun-Chih Huang, Helain J Landy
1Obstetrics and Gynecology, MedStar Washington Hospital Center, Washington, DC; the Department of Biostatistics and Epidemiology, MedStar Health Research Institute, Hyattsville, Maryland; and Georgetown-Howard Universities Center for Clinical and Translational Science and Obstetrics and Gynecology, MedStar Georgetown University Hospital, Washington, DC.
Objective:
To examine the rate of surgical site infection according to the choice of antibiotics in women undergoing cesarean delivery.
Methods:
We conducted a retrospective cohort study of women undergoing cesarean delivery (labored, unlabored, and scheduled) from 2012 to 2017. Women with chorioamnionitis and those who did not receive any antibiotics were excluded. Our primary outcome was defined a priori as a composite of cellulitis, endometritis, deep wound infection, abdominopelvic abscess, and sepsis. Outcomes were examined according to the choice of antibiotics: cefazolin, a standard alternative (both clindamycin and gentamicin), and inappropriate alternatives (such as clindamycin only). A multivariable logistic regression model was used to calculate the propensity score for each observation, which was the probability of receiving a particular antibiotic regimen. The propensity score-adjusted logistic regression models were conducted to calculate adjusted odds ratios (ORs) and 95% CIs. Firth's penalized likelihood approach was applied to address issues of rare events.
Results:
Among 6,584 selected women, 6,163 (93.6%), 274 (4.2%), and 147 (2.2%) received cefazolin, a standard alternative, and inappropriate alternatives, respectively. Use of standard alternative antibiotics compared with cefazolin was not associated with increased odds of the primary outcome (crude OR 1.50 [0.92-2.46]; adjusted OR 1.63 [0.97-2.60]) but was associated with increased odds of cellulitis (crude OR 2.07 [1.16-3.70]; adjusted OR 1.93 [1.03-3.31]). Use of inappropriate alternative antibiotics compared with cefazolin was associated with increased odds of the primary outcome (crude OR 4.37 [2.80-6.83]; adjusted OR 4.13 [2.59-6.36]) as well as some components of the composite outcome such as endometritis before discharge (crude OR 6.85 [3.94-11.90]; adjusted OR 6.68 [3.69-11.44]) and cellulitis (crude OR 3.36 [1.78-6.34]; adjusted OR 3.23 [1.63-5.81]).
Conclusion:
Both standard alternative and inappropriate alternatives were associated with increased odds of surgical site infections compared with cefazolin.
Related Concept Videos
00:57Antibiotic Selection
01:20Mate Choice
01:19Personal Choice and Fate Attributions
01:30Development of Antibiotic Resistance
01:10Factors Affecting α-Alkylation of Ketones: Choice of Base
The reaction involving bases like EtO− whose conjugate acid EtOH (pKa = 15.9) is stronger than the ketone (pKa = 19.2) results in an equilibrium mixture with higher ketone concentration. As a consequence,...
01:20Infection
The chain begins with pathogens: bacteria, viruses, fungi, prions, or parasites such as protozoa helminths. These can be present on the skin as transient or resident flora, or they can be acquired from the environment. Identifying and treating the type of infection and...