Infection Control Section, Mae Sot Hospital, 175/16 Sri Panich Road, Mae Sot Sub-district, Mae Sot District, Tak, 63110 Thailand.
2Division of Nursing Science, Faculty of Nursing, Chiang Mai University, 110 Inthawaroros Road, Sriphum Sub-district, Muang District, Chiang Mai, 50200 Thailand.
Antimicrob Resist Infect Control. 2018 Jan 22;7:13. doi: 10.1186/s13756-018-0304-6. eCollection 2018.
Cesarean surgical site infections (SSIs) can be prevented by proper preoperative antibiotic prophylaxis. Differences in antibiotic selection in clinical practice exist according to obstetricians' preferences despite clear guidelines on preoperative antibiotic prophylaxis. This study aimed to compare the efficacy of ampicillin and ceftriaxone in preventing cesarean SSIs.
The observational prospective cohort study was conducted at a tertiary hospital in Thailand from 1 January 2007 to 31 December 2012. Propensity scores for ceftriaxone prophylaxis were calculated from potential influencing confounders. The cesarean SSI rates of the ceftriaxone group vs. those of the ampicillin prophylactic group were estimated by multilevel mixed-effects Poisson regression nested by propensity score.
Data of 4149 cesarean patients were collected. Among these, 911 patients received ceftriaxone whereas 3238 patients received ampicillin as preoperative antibiotic prophylaxis. The incidence of incisional SSIs was (0.1% vs. 1.2%; = 0.001) and organ space SSIs was (1.2% vs. 2.9%; = 0.003) in the ceftriaxone group compared with the ampicillin group. After adjusting for confounders, the rate ratios of incisional and organ/space SSIs in the ceftriaxone compared with the ampicillin group did not differ (RR, 0.23; 95% CI 0.03-1.78), and (RR, 1.62; 95% CI 0.83-3.18), respectively.
These data indicate no difference exists between ampicillin and ceftriaxone to prevent SSIs after cesarean section. Ampicillin may be used as antibiotic prophylaxis in cesarean section.
剖宫产术部位感染（SSI）可以通过术前适当的抗生素预防来预防。尽管有明确的术前抗生素预防指南，但根据产科医生的偏好，临床实践中抗生素的选择存在差异。本研究旨在比较氨苄西林和头孢曲松预防剖宫产术 SSI 的疗效。
本观察性前瞻性队列研究于 2007 年 1 月 1 日至 2012 年 12 月 31 日在泰国的一家三级医院进行。从潜在的影响混杂因素中计算头孢曲松预防的倾向评分。通过多水平混合效应泊松回归嵌套倾向评分，估计头孢曲松组与氨苄西林预防性组的剖宫产术 SSI 发生率。
共收集了 4149 例剖宫产患者的数据。其中，911 例患者接受头孢曲松治疗，3238 例患者接受氨苄西林作为术前抗生素预防。与氨苄西林组相比，头孢曲松组的切口 SSI 发生率为（0.1% vs. 1.2%；=0.001）和器官间隙 SSI 发生率为（1.2% vs. 2.9%；=0.003）。调整混杂因素后，头孢曲松组与氨苄西林组相比，切口和器官/间隙 SSI 的率比无差异（RR，0.23；95%CI 0.03-1.78）和（RR，1.62；95%CI 0.83-3.18）。
这些数据表明，氨苄西林和头孢曲松在预防剖宫产术后 SSI 方面没有差异。氨苄西林可用于剖宫产术的抗生素预防。
