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Cesarean delivery is the most common major surgical procedure performed on women in the United States. In 2012, 1.3 million of the 4 million births in the United States (32.8%) were by cesarean. 1 Infectious morbidity is one of the most common complications, affecting 2-20% of cesareans, depending on the population. 2 Although some infections are superficial, a significant proportion are more severe and involve deeper abdominal wall tissue, the peritoneal cavity, or the uterus. 3 These require prolonged hospitalization, readmissions, or additional outpatient visits. The sheer numbers of these infections represent a substantial burden for individuals and the health care system. 4 Although costs vary, depending on the location, depth, and severity, the average attributable cost for each cesarean infection is estimated to be $2800-3400. 5 </P>Preoperative antibiotic prophylaxis has been established as an effective preventive measure for reducing postcesarean infections. The Cochrane review of randomized trials suggests a 60% decrease in postcesarean infections when antibiotic prophylaxis is used at cesarean delivery. 2 In addition, pooled results from five randomized trials showed a further 50% reduction in the risk of endometritis and a possibly lower rate of wound infections when antibiotics are administered prior to skin incision
American Journal of Obstetrics and Gynecology – Wolters Kluwer Health
Published: Oct 1, 2014
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