An international survey of practice variation in the use of antibiotic prophylaxis in cesarean section.
OBJECTIVE
To examine the use of antibiotic prophylaxis in cesarean section in different countries and in relation to a reference regimen.


METHODS
Fifty consecutive cesarean sections performed in eight centers in five countries were surveyed. Data from each center were compared to a regimen recommended by the Cochrane Collaboration (one dose of ampicillin or cefazolin administered to all women shortly before the procedure or immediately after cord clamping) using logistic regression with adjustment for procedure type.


RESULTS
Prophylaxis was used widely, but only four centers administered prophylaxis to all women. Ampicillin and cefazolin were the principal antibiotics used, but broad-spectrum agents and multidrug regimens were also used commonly. Only two centers reliably administered the antibiotic at the appropriate time. The majority of women received only one dose of antibiotic in only three centers.


CONCLUSIONS
The use of antibiotic prophylaxis in cesarean section was variable and often at odds with published recommendations.
Huskins
W C
WC
Mayo Medical School, MN, Rochester, USA. huskins.charles@mayo.edu
Ba-Thike
K
K
Festin
M R
MR
Limpongsanurak
S
S
Lumbiganon
P
P
Peedicayil
A
A
Purwar
M
M
Shenoy
S
S
Goldmann
D A
DA
Tolosa
J E
JE
D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data*; D002585:Cesarean Section / Q000379:methods*; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D007194:India; D002052:Myanmar; D010679:Philippines; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011247:Pregnancy; D013530:Surgical Wound Infection / Q000517:prevention & control*; D013785:Thailand; D014481:United States