Department of Obstetrics and Gynecology, University of Saskatchewan, Regina, SK.
Department of Obstetrics and Gynecology, University of Saskatchewan, Regina, SK.
J Obstet Gynaecol Can. 2021 Sep;43(9):1062-1068.e2. doi: 10.1016/j.jogc.2020.12.016. Epub 2021 Jan 5.
The purpose of this quality improvement study was to determine the effect of adding azithromycin to standard antibiotic prophylaxis on the rates surgical site infection (SSI) in women undergoing both elective and non-elective cesarean deliveries at our centre.
A before-and-after quality improvement study was conducted at the Regina General Hospital in Regina, Saskatchewan. Data collected from 989 women who had a caesarean delivery between June 1, 2016 and June 30, 2017 were compared with those from 1033 women who had a caesarean delivery between August 1, 2017 and July 31, 2018, after the introduction of adjunctive azithromycin prophylaxis. The primary outcome measure was the change in the incidence of SSI up to 30 days following surgery. Secondary outcome measures included timing of azithromycin prophylaxis and the number of women who did not receive azithromycin.
Surgical site infection rates decreased from 3.5% to 2.9% after adjunctive azithromycin prophylaxis was introduced. The absolute reduction in SSIs of 0.6% was not statistically significant (P = 0.42). There were no differences in SSI rates between the elective and non-elective subgroups.
Adding azithromycin to the standard antibiotic prophylaxis for cesarean delivery showed no statistically significant reduction in SSI rates in a population with low baseline rates of SSI.
本质量改进研究旨在确定在我们中心行择期和非择期剖宫产的女性中，在标准抗生素预防方案中添加阿奇霉素对手术部位感染（SSI）发生率的影响。
在萨斯喀彻温省里贾纳的里贾纳综合医院进行了一项前后对照的质量改进研究。比较了 2016 年 6 月 1 日至 2017 年 6 月 30 日期间 989 例剖宫产患者的数据，与 2017 年 8 月 1 日至 2018 年 7 月 31 日期间接受辅助阿奇霉素预防后 1033 例剖宫产患者的数据。主要结局指标为术后 30 天内 SSI 的发生率变化。次要结局指标包括阿奇霉素预防的时机和未接受阿奇霉素的女性人数。
在辅助阿奇霉素预防后，SSI 发生率从 3.5%降至 2.9%。SSI 绝对减少 0.6%，无统计学意义（P=0.42）。择期和非择期亚组的 SSI 发生率无差异。
在 SSI 发生率基线较低的人群中，在标准抗生素预防方案中添加阿奇霉素并未显著降低剖宫产的 SSI 发生率。
