Comparing prophylactic use of cefazolin for SSI in cesarean section: a systematic review and meta-analysis
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REVIEW
Comparing prophylactic use of cefazolin for SSI in cesarean section: a systematic review and meta‑analysis Meilin Li1 · Bingzhi Shi1 · Junru Ma1 · Xinyue Peng1 · Jiemin Shi1 Received: 1 June 2020 / Accepted: 3 November 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To summarize the available evidence to explore the effect of different prophylactic cefazolin regimens on postoperative surgical site infection after cesarean section. Methods We searched WOS, Pubmed, and EMBASE Database also traced citations in the reference sections of the retrieved studies. English search words: Cesarean section, Surgical site infection, Cefazolin. The majority of the literature are randomized controlled trials comparing varied regimens of cefazolin. Results A total of 11 randomized controlled trials and 4 non-randomized controlled trials involving 16,328 pregnant women were eligible. There was no statistically significant difference in the risk of SSI after cesarean section when cefazolin was given at a high dose compared with cefazolin at a low dose (OR 0.77, 95% CI 0.57–1.04, I2 = 0.0%). The risk of SSI after cesarean section was reduced by prophylactic use of cefazolin before skin incision compared with that after the umbilical cord clamping (OR 0.48, 95% CI 0.29–0.82, I2 = 53.4%). Because of the extreme heterogeneity of the combined drug use, no meta-analysis results were provided. The consequences of cefazolin combined with other antibiotics (either orally or intravenously) vary widely. For pregnant women with different risk factors, cefazolin alone or the type, dose and drug route of cefazolin combined with additional antibiotics need to be further studied and explored. Conclusions All in all, this article illustrates a better use of cefazolin for the control of Surgical incision site infection in the cesarean section. For pregnant women with cesarean section without high-risk factors of infection, the use of cefazolin is effective, but for pregnant women with different high-risk factors, the specific use of prophylactic antibiotics needs to be further explored. Keywords Cefazolin · Surgical site infection · Cesarean section
Introduction Cesarean section is an important means to solve the acute and critical cases of obstetrics. With the development of the cesarean section, the rate of cesarean section is increasing all over the world [1]. Some studies have demonstrated that cesarean section has a worse impact on pregnant women than vaginal delivery [2, 3], for example, the incidence of maternal infection after cesarean section is 5 to 20 times [3]. Guidelines of the American Association of Obstetricians and Gynecologists recommend the use of antibiotics for prevention of cesarean section, reducing the impact of * Junru Ma [email protected] 1
The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
postoperative fever, endometritis, surgical site infections and serious maternal infectious complications. Surgical site infections (SSI, including wo
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