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剖宫产的抗生素预防:美国母胎医学医师调查

Antibiotic prophylaxis for cesarean delivery: survey of maternal-fetal medicine physicians in the U.S.

作者信息

Doss Amy E, Davidson Jennifer D, Cliver Suzanne P, Wetta Luisa A L, Andrews William W, Tita Alan T N

机构信息

Department of Obstetrics and Gynecology, Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama 35233, USA.

出版信息

J Matern Fetal Neonatal Med. 2012 Aug;25(8):1264-6. doi: 10.3109/14767058.2011.605485. Epub 2012 May 3.

DOI:10.3109/14767058.2011.605485
PMID:21762043
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4074423/
Abstract

OBJECTIVE

To describe practices concerning antibiotic prophylaxis for cesarean delivery among maternal-fetal medicine (MFM) physicians in the United States.

METHODS

A 10-item self-administered survey about their routine use of antibiotics for cesarean delivery was mailed once only to a random sample of 1000 US-based fellows of the Society of Maternal-Fetal Medicine in November 2009.

RESULTS

There were a total of 250 respondents from 40 US states between 10/09 and 4/2010, corresponding to a response rate of 25%. Among respondents, 95.5% reported routine use of a cephalosporin only (including 84.4% who reported use of cefazolin) as antibiotic prophylaxis for cesarean delivery; less than 3% reported use of an extended spectrum regimen such as cefazolin + azithromycin. Preoperative administration of antibiotic prophylaxis was reported by 84.6% compared to 15.0% who reported giving antibiotic prophylaxis after umbilical cord clamping. Administration of a single dose of antibiotic was reported by 96%.

CONCLUSION

The majority of MFM specialists in the US report routine and preoperative use of a single prophylactic dose of a 1st generation cephalosporin for cesarean delivery.

摘要

目的

描述美国母胎医学(MFM)医生在剖宫产抗生素预防方面的做法。

方法

2009年11月,一项关于剖宫产抗生素常规使用情况的10项自填式调查问卷仅被邮寄给1000名美国母胎医学会会员的随机样本一次。

结果

在2009年10月至2010年4月期间,共有来自美国40个州的250名受访者,回复率为25%。在受访者中,95.5%报告仅常规使用头孢菌素(包括84.4%报告使用头孢唑林)作为剖宫产的抗生素预防;不到3%报告使用如头孢唑林+阿奇霉素等广谱方案。84.6%的人报告在术前给予抗生素预防,相比之下,15.0%的人报告在脐带夹紧后给予抗生素预防。96%的人报告给予单剂量抗生素。

结论

美国大多数MFM专家报告在剖宫产时常规且术前使用单剂量第一代头孢菌素进行预防。

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本文引用的文献

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Committee opinion no. 465: antimicrobial prophylaxis for cesarean delivery: timing of administration.委员会意见第 465 号:剖宫产术抗菌预防用药:给药时机。
Obstet Gynecol. 2010 Sep;116(3):791-792. doi: 10.1097/AOG.0b013e3181f68086.
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Antimicrobial prophylaxis for cesarean delivery before skin incision.剖宫产皮肤切开前的抗菌预防。
Obstet Gynecol. 2009 Sep;114(3):573-579. doi: 10.1097/AOG.0b013e3181b490f1.
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Emerging concepts in antibiotic prophylaxis for cesarean delivery: a systematic review.剖宫产抗生素预防的新观念:一项系统评价
Obstet Gynecol. 2009 Mar;113(3):675-682. doi: 10.1097/AOG.0b013e318197c3b6.
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Effect of a change in policy regarding the timing of prophylactic antibiotics on the rate of postcesarean delivery surgical-site infections.预防性抗生素使用时机政策的改变对剖宫产术后手术部位感染发生率的影响。
Am J Obstet Gynecol. 2008 Sep;199(3):310.e1-5. doi: 10.1016/j.ajog.2008.07.009.
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Impact of extended-spectrum antibiotic prophylaxis on incidence of postcesarean surgical wound infection.广谱抗生素预防对剖宫产术后手术伤口感染发生率的影响。
Am J Obstet Gynecol. 2008 Sep;199(3):303.e1-3. doi: 10.1016/j.ajog.2008.06.068.
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Timing of perioperative antibiotics for cesarean delivery: a metaanalysis.剖宫产围手术期抗生素的使用时机:一项荟萃分析
Am J Obstet Gynecol. 2008 Sep;199(3):301.e1-6. doi: 10.1016/j.ajog.2008.06.077.
7
Decreasing incidence of postcesarean endometritis with extended-spectrum antibiotic prophylaxis.延长预防性使用广谱抗生素可降低剖宫产术后子宫内膜炎的发病率
Obstet Gynecol. 2008 Jan;111(1):51-6. doi: 10.1097/01.AOG.0000295868.43851.39.
8
Administration of cefazolin prior to skin incision is superior to cefazolin at cord clamping in preventing postcesarean infectious morbidity: a randomized, controlled trial.剖宫产皮肤切开前使用头孢唑林在预防剖宫产术后感染性并发症方面优于脐带钳夹时使用头孢唑林:一项随机对照试验。
Am J Obstet Gynecol. 2007 May;196(5):455.e1-5. doi: 10.1016/j.ajog.2007.03.022.
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Timing of prophylactic antibiotic administration in the uninfected laboring gravida: a randomized clinical trial.未感染的临产孕妇预防性使用抗生素的时机:一项随机临床试验。
Am J Obstet Gynecol. 2005 Jun;192(6):1864-8; discussion 1868-71. doi: 10.1016/j.ajog.2004.12.063.
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ACOG practice bulletin number 47, October 2003: Prophylactic Antibiotics in Labor and Delivery.美国妇产科医师学会实践公告第47号,2003年10月:分娩期预防性抗生素应用
Obstet Gynecol. 2003 Oct;102(4):875-82. doi: 10.1016/s0029-7844(03)00984-0.