Extended antibiotic prophylaxis for prevention of surgical-site infections in morbidly obese women who undergo combined hysterectomy and medically indicated panniculectomy: a cohort study.
OBJECTIVE
The purpose of this study was to compare surgical-site infection rates in obese women who had extended prophylactic antibiotic (EPA) vs standard prophylactic antibiotic.


METHODS
An electronic records-linkage system identified 145 obese women (body mass index, >30 kg/m(2)) who underwent combined hysterectomy and panniculectomy from January 1, 2005, through December 31, 2008. The EPA cohort received standard antibiotics (cefazolin, 2 g) and continued oral antibiotic (ciprofloxacin) until removal of drains. Regression models were used to adjust for known confounders.


RESULTS
The mean age was 56.0 + or - 12.1 years, and mean body mass index was 42.6 + or - 8.4 kg/m(2) (range, 30-86.4 kg/m(2)). The EPA cohort experienced fewer surgical-site infections (6 [5.9%] vs 12 [27.9%]; P < .001; adjusted odds ratio, 0.16; 95% confidence interval, 0.04-0.51; P < .001), had lower probability of incision and drainage (3 [2.9%] vs 5 [11.6%]; P = .05), and required fewer infection-related admissions (5 [4.9%] vs 6 [13.9%]; P = .08).


CONCLUSIONS
Extended antibiotic prophylaxis can reduce surgical-site infections in obese women after combined hysterectomy and panniculectomy.
El-Nashar
Sherif A
SA
Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN 55905, USA.
Diehl
Courtenay L
CL
Swanson
Casey L
CL
Thompson
Rodney L
RL
Cliby
William A
WA
Famuyide
Abimbola O
AO
Stanhope
C Robert
CR
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D019072:Antibiotic Prophylaxis / Q000379:methods*; D015992:Body Mass Index; D002437:Cefazolin / Q000008:administration & dosage; D002939:Ciprofloxacin / Q000008:administration & dosage; D015331:Cohort Studies; D004322:Drainage; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications*; D015242:Ofloxacin / Q000008:administration & dosage; D012189:Retrospective Studies; D050507:Subcutaneous Fat, Abdominal / Q000601:surgery*; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*
D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin; D019980:Amoxicillin-Potassium Clavulanate Combination; D015242:Ofloxacin; D002437:Cefazolin