McLaren Rodney A, Atallah Fouad, Minkoff Howard
Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, New York.
Department of Obstetrics and Gynecology, SUNY Downstate Medical Center, Brooklyn, New York.
AJP Rep. 2020 Apr;10(2):e155-e158. doi: 10.1055/s-0040-1709513. Epub 2020 Apr 15.
Surgical site infections are common complications of cesarean delivery. Many recent studies, including meta-analyses, have assessed the efficacy of antibiotic prophylaxis. Those articles have demonstrated that preincision antibiotic prophylaxis reduces the incidence of surgical site infections postcesarean, and that the use of adjunctive azithromycin further reduces infection after nonelective cesarean deliveries. However, long-term effects of fetal exposure to antibiotic prophylaxis-including asthma, obesity, and alterations in microbiota-have also been demonstrated. We suggest that while studies of optimal antibiotic regimens proceed, considerations of the potential risks to the neonate should be factored into discussions of benefits and burdens.
手术部位感染是剖宫产常见的并发症。包括荟萃分析在内的许多近期研究评估了抗生素预防的效果。这些文章表明，切开前使用抗生素预防可降低剖宫产术后手术部位感染的发生率，并且在非选择性剖宫产中使用辅助性阿奇霉素可进一步降低感染率。然而，胎儿暴露于抗生素预防的长期影响——包括哮喘、肥胖和微生物群改变——也已得到证实。我们建议，在进行最佳抗生素方案研究的同时，在讨论益处和负担时应考虑对新生儿的潜在风险。
