title: Antibiotics prophylaxis in connection with caesarean section--guidelines at Norwegian maternity departments.
abstract: BACKGROUND
  The frequency of caesarean sections is increasing. Infection in operation wounds and/or underlying spaces and organs is a common complication. In Veileder I fødselshjelp [Clinical Guidelines in Obstetrics], 2008, antibiotic prophylaxis is recommended in the form of single dose ampicillin or first generation cephalosporins in connection with acute caesarean sections and under special conditions such as prolonged operations. We wanted to find out whether Norwegian maternity departments follow these recommendations.
  
  
  METHODS
  All head senior consultants at maternity departments that carried out more than one caesarean section in 2008 were invited to take part in a survey of the department's written guidelines for use of antibiotic prophylaxis in connection with caesarean section. The extent to which the guidelines were followed was evaluated using data from the Norwegian Surveillance System for Hospital-Associated Infections (NOIS).
  
  
  RESULTS
  38 of the 42 maternity wards in the investigation had written guidelines for antibiotic prophylaxis. Four of these maternity wards gave prophylaxis in all Caesarean sections, one only on indication, and 33 in acute Caesarean section. The guidelines varied as regards choice of type of antibiotic and time of administration. In the maternity wards with written guidelines recommending use of antibiotic prophylaxis in all Caesarean sections, were practice in accordance with the guidelines. When the guidelines recommended prophylactic use only in acute operations, there was agreement between practice and guidelines in 71 % to 97 % of the patients in the ward.
  
  
  CONCLUSIONS
  Most Norwegian maternity wards have written guidelines on antibiotic prophylaxis in Caesarean section. The contents of the guidelines varied but are mainly in agreement with current Norwegian recommendations.
authors.affiliation: Department of Infectious Disease Epidemiology, Norwegian Institute of Public Health, Norway. hmer@fhi.no
authors.forename: Hanne-Merete
authors.initials: HM
authors.lastname: Eriksen
authors.forename: Anja Ramberg
authors.initials: AR
authors.lastname: Sæther
authors.forename: Inger
authors.initials: I
authors.lastname: Økland
authors.forename: Ellen
authors.initials: E
authors.lastname: Langen
authors.forename: Ylva
authors.initials: Y
authors.lastname: Sandness
authors.forename: Anne
authors.initials: A
authors.lastname: Bødtker
authors.forename: Finn Egil
authors.initials: FE
authors.lastname: Skjeldestad
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D019072:Antibiotic Prophylaxis; D002585:Cesarean Section / Q000009:adverse effects; D005260:Female; D006801:Humans; D009664:Norway; D009775:Obstetrics and Gynecology Department, Hospital; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D013530:Surgical Wound Infection / Q000517:prevention & control*
chemical_list: D000900:Anti-Bacterial Agents