title: Impact of extended-spectrum antibiotic prophylaxis on incidence of postcesarean surgical wound infection.
abstract: OBJECTIVE
  We assessed the impact of an extended-spectrum antibiotic prophylaxis regimen (azithromycin in addition to recommended narrow-spectrum cephalosporin) on postcesarean incisional wound infection.
  
  
  METHODS
  Data from prospective surveillance of surgical site infections at our institution were used to compare incidence in postcesarean incisional wound infection for 3 consecutive time periods of antibiotic prophylaxis: (1) standard (ie, cephalosporin only, 1992-1996); (2) clinical trial of extended spectrum (ie, extended vs cephalosporin only, 1997-1999); and (3) routine use of extended spectrum (2001-2006).
  
  
  RESULTS
  The incidence of postcesarean incisional wound infections decreased progressively from 3.1% to 2.4% and then to 1.3% over the 3 consecutive periods (P value for trend < .002).
  
  
  CONCLUSIONS
  Increasing the use of extended-spectrum antibiotic prophylaxis at our institution over 3 time periods was associated with a decreasing trend in postcesarean incisional wound infection.
authors.affiliation: Center for Women's Reproductive Health, Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA.
authors.forename: Alan T N
authors.initials: AT
authors.lastname: Tita
authors.forename: John
authors.initials: J
authors.lastname: Owen
authors.forename: Alan M
authors.initials: AM
authors.lastname: Stamm
authors.forename: Anne
authors.initials: A
authors.lastname: Grimes
authors.forename: John C
authors.initials: JC
authors.lastname: Hauth
authors.forename: William W
authors.initials: WW
authors.lastname: Andrews
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D017963:Azithromycin / Q000627:therapeutic use*; D002511:Cephalosporins / Q000008:administration & dosage / Q000627:therapeutic use*; D002585:Cesarean Section; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D015994:Incidence; D011247:Pregnancy; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control*
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D017963:Azithromycin