Reiff Emily S, Habib Ashraf S, Carvalho Brendan, Raghunathan Karthik
Durham, NC, Department of Obstetrics and Gynecology, Duke University, USA.
Durham, NC, Department of Anesthesiology, Duke University, USA.
Anesthesiol Res Pract. 2020 Dec 16;2020:3741608. doi: 10.1155/2020/3741608. eCollection 2020.
The most common complication after cesarean delivery is surgical site infection. Antibiotic prophylaxis reduces infectious morbidity and current anesthetic quality metrics include preincision antibiotic prophylaxis. Recently, studies suggest reductions in infectious morbidity with the addition of azithromycin for unscheduled cesarean delivery. Larger doses of cefazolin are recommended for morbidly obese women, but evidence is conflicting. The aim of this study was to survey anesthesiologists to assess current practice for antibiotic prophylaxis for cesarean delivery.
We invited a random sample of 10,000 current members of the American Society of Anesthesiologists to complete an online survey about their current practice of antibiotic prophylaxis for cesarean delivery in November 2017. The survey included questions similar to a previous survey on this topic in 2012.
The response rate was 12.2% ( = 1223). Most respondents had at least 15 years of experience (684, 55.9%), work at a nonteaching or community hospital (729, 59.6%), with >500 cesarean deliveries annually (619, 50.6%), and administer obstetric anesthesia several times a week (690, 56.4%). Routine preincision antibiotic prophylaxis was reported by 1162 (95.0%) of the 1223 respondents, a substantial improvement versus the 63.5% reported in the previous study in 2012. For intrapartum cesarean deliveries, 141 (11.5%) administer azithromycin for unscheduled cesarean deliveries. Those who use cefazolin, 509 (42.5%) administer 3 g for morbidly obese women.
Adherence to preincision antibiotic prophylaxis for cesarean delivery is very high, a significant improvement within 5 years. A minority of anesthesiologists utilize azithromycin for intrapartum cesarean deliveries. The dose of cefazolin for morbidly obese women varies widely.
剖宫产术后最常见的并发症是手术部位感染。抗生素预防可降低感染发病率，当前的麻醉质量指标包括术前抗生素预防。最近，研究表明，对于非计划剖宫产加用阿奇霉素可降低感染发病率。对于病态肥胖女性，建议使用更大剂量的头孢唑林，但证据存在矛盾。本研究的目的是调查麻醉医生，以评估剖宫产抗生素预防的当前实践情况。
2017年11月，我们随机邀请了10000名美国麻醉医师协会的现任会员完成一项关于他们当前剖宫产抗生素预防实践的在线调查。该调查包括与2012年关于该主题的先前调查类似的问题。
回复率为12.2%（n = 1223）。大多数受访者至少有15年经验（684人，55.9%），在非教学医院或社区医院工作（729人，59.6%），每年进行超过500例剖宫产（619人，50.6%），每周进行几次产科麻醉（690人，56.4%）。1223名受访者中有1162人（95.0%）报告了常规术前抗生素预防，与2012年先前研究报告的63.5%相比有显著改善。对于产时剖宫产，141人（11.5%）在非计划剖宫产时使用阿奇霉素。使用头孢唑林的人中，509人（42.5%）为病态肥胖女性使用3g剂量。
剖宫产术前抗生素预防的依从性非常高，在5年内有显著改善。少数麻醉医生在产时剖宫产中使用阿奇霉素。病态肥胖女性使用的头孢唑林剂量差异很大。
