title: Prophylactic administration of cefazolin prior to skin incision versus antibiotics at cord clamping in preventing postcesarean infectious morbidity: a systematic review and meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  To summarize the published evidence of prophylactic cefazolin for cesarean delivery given before the procedure versus at cord clamping.
  
  
  METHODS
  We systematically searched the databases of PubMed, Embase, and CENTRAL in the Cochrane Library for randomized controlled trials that compared prophylactic antibiotics with cefazolin for cesarean delivery given before the procedure versus at cord clamping.
  
  
  RESULTS
  Six randomized controlled trials with high quality were included in this meta-analysis. Preoperative administration significantly reduced the risk of postpartum endometritis (RR: 0.57, 95% CI: 0.36-0.90, p = 0.02). Preoperative administration of cefazolin was not associated with a significant reduction in the risk of wound infection (RR: 0.70, 95% CI: 0.43-1.12) and urinary tract infection (RR: 1.19, 95% CI: 0.53-2.63). Furthermore, preoperative administration of cefazolin did not significantly affect proven neonatal sepsis (RR: 0.82, 95% CI: 0.47-1.42), suspected neonatal sepsis that requires a workup (RR: 0.94, 95% CI: 0.72-1.22), or neonatal intensive care unit admissions (RR: 0.90, 95% CI: 0.62-1.28).
  
  
  CONCLUSIONS
  Pooled results demonstrated that antibiotic prophylaxis with cefazolin for cesarean delivery that is given before skin incision can significantly decrease the incidence of postpartum endometritis.
authors: Department of Obstetrics, Linyi People's Hospital, Linyi, China.
authors: Juxiang
authors: J
authors: Sun
authors: Mingxia
authors: M
authors: Ding
authors: Jinhua
authors: J
authors: Liu
authors: Yurong
authors: Y
authors: Li
authors: Xinghui
authors: X
authors: Sun
authors: Tianfeng
authors: T
authors: Liu
authors: Ying
authors: Y
authors: Chen
authors: Jing
authors: J
authors: Liu
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000379:methods*; D002437:Cefazolin / Q000627:therapeutic use*; D002585:Cesarean Section; D003250:Constriction; D004716:Endometritis / Q000517:prevention & control; D005260:Female; D006801:Humans; D021041:Placental Circulation / Q000502:physiology; D011183:Postoperative Complications; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control*; D057234:Preoperative Period; D016032:Randomized Controlled Trials as Topic; D013530:Surgical Wound Infection / Q000517:prevention & control; D014470:Umbilical Cord / Q000098:blood supply*; D014552:Urinary Tract Infections / Q000517:prevention & control
chemical_list: D000900:Anti-Bacterial Agents; D002437:Cefazolin