Antibiotic profylaxis in obstetrics

Czech version

Authors: E. Menzlová; J. Záhumenský; E. Kučera
Authors‘ workplace: Gynekologicko-porodnická klinika FNKV a 3. LF UK, Praha, přednosta doc. MUDr. E. Kučera, CSc.
Published in: Ceska Gynekol 2013; 78(3): 295-301

Overview

Nosocomial infections increase health care costs significantly and they are a real threat for all hospitalised patients as well. Surgical procedures affect imunological integrity in patients and increase risk of contamination and subsequent incidence of surgical site infections (SSIs). Antibiotic profylaxis according to recent trials has been shown to be effective in reducing the risks of postoperative infectious complications particularly in women undergoing cesarean section, termination of pregnancy in I. and II. trimester and repair of extensive obstetric perineal injuries. Benefit of antibiotic profylaxis hasn‘ t been proven in procedures such as amniocentesis, cerclage and manual uterine evacuation. The routine antibiotic administration isn‘t recommanded in cases of spontaneous preterm labour without membrane rupture due to an increased risk of worse long-term outcome of children.The authors present also recent studies regarding antivirotic profylaxis in pregnant women with hepatitis B and herpes genitalis recidivans. In the end of the article differences in antimicrobial administration in obese women and in patients with penicillin allergy anamnesis are mentioned.

Keywords:
antibiotic profylaxis – obstetrics – surgery –nosocomial infections

Sources

1. Perencevich, EN., Stone, PW., Wright, SB., et al. Raising standards while watching the bottom line: making a business case for infection control. Infect Control Hosp Epidemiol, 2007, 28, 10, p. 1121–1133.

2. Anderson, DJ., Kirkland, KB., Kaye, KS., et al. Underresour-ced hospital infection control and prevention programs: penny wise, pound foolish? Infect Control Hosp Epidemiol, 2007, 28, 7, p. 767–773.

3. Kerwat, K., Graf, J., Wulf, H. [Nosocomial infections]. Anasthesiol Intensivmed Notfallmed Schmerzther, 2010, 45, 1, p. 30–31.

4. Clifford, V., Daley, A. Antibiotic prophylaxis in obstetric and gynaecological procedures: a review. Aust N Z J Obstet Gynaecol, 2012, 52, 5, p. 412–419.

5. Kirkland, KB., Briggs, JP., Trivette, SL., et al. The impact of surgical-site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs. Infect Control Hosp Epidemiol, 1999, 20, 11, p. 725–730.

6. Mangram, AJ., Horan, TC., Pearson, ML., et al. Guideline for Prevention of Surgical Site Infection, 1999. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee. Am J Infect Control, 1999, 27, 2, p. 97–132, 133–134, 96.

7. Cruse, PJ., Foord, R. The epidemiology of wound infection. A 10-year prospective study of 62,939 wounds. Surg Clin North Am, 1980, 60, 1, p. 27–40.

8. Dellinger, EP., Gross, PA., Barrett, TL., et al. Quality standard for antimicrobial prophylaxis in surgical procedures. The Infectious Diseases Society of America. Infect Control Hosp Epidemiol, 1994, 15, 3, p. 182–188.

9. Morrill, MY., Schimpf, MO., Abed, H., et al. Antibiotic prophylaxis for selected gynecologic surgeries. Int J Gynaecol Obstet, 2013, 120, 1, p. 10–15.

10. Harbarth, S., Samore, MH., Lichtenberg, D., Carmeli, Y. Is prolonged antibiotic prophylaxis after major surgery associated with an increased risk of nosocomial bloodstream infection? J Am Coll Surg, 2000, 190, 4, p. 503–504.

11. Van Eyk, N., van Schalkwyk, J. Antibiotic prophylaxis in gynaecologic procedures. J Obstet Gynaecol Can, 2012, 34, 4, p. 382–391.

12. Tanner, J., Norrie, P., Melen, K. Preoperative hair removal to reduce surgical site infection. Cochrane Database Syst Rev, 2011, 11, p. D4122.

13. Jones, RN., Wojeski, W., Bakke, J., et al. Antibiotic prophylaxis of 1,036 patients undergoing elective surgical procedures. A prospective, randomized comparative trial of cefazolin, cefoxitin, and cefotaxime in a prepaid medical practice. Am J Surg, 1987, 153, 4, p. 341–346.

14. Keski-Nisula, L., Kirkinen, P., Oilikainen, M., Saarikosi, S. C-reactive protein in uncomplicated parturients delivered by cesarean section Acta Obstet Gynecol Scand, 1997, 76, 9, p. 862–867.

15. Achilles, SL., Reeves, MF. Prevention of infection after induced abortion: release date October 2010: SFP guideline 20102. Contraception, 2011, 83, 4, p. 295–309.

16. Osser, S., Persson, K. Postabortal infectious morbidity after antibiotic treatment of chlamydia-positive patients. Sex Transm Dis, 1989, 16, 2, p. 84–87.

17. Low, N., Mueller, M., Van Vliet, HA., Kapp, N. Perioperative antibiotics to prevent infection after first-trimester abortion. Cochrane Database Syst Rev, 2012, 3, p. D5217.

18. Levallois, P., Rioux, JE. Prophylactic antibiotics for suction curettage abortion: results of a clinical controlled trial. Am J Obstet Gynecol, 1988, 158, 1, p. 100–105.

19. Heisterberg, L., Petersen, K. Metronidazole prophylaxis in elective first trimester abortion. Obstet Gynecol, 1985, 65, 3, p. 371–374.

20. Chen, S., Li, J., van den Hoek, A. Universal screening or prophylactic treatment for Chlamydia trachomatis infection among women seeking induced abortions: which strategy is more cost-effective? Sex Transm Dis, 2007, 34, 4, p. 230–236.

21. Crowley, T., Low, N., Turner, A., et al. Antibiotic prophylaxis to prevent post-abortal upper genital tract infection in women with bacterial vaginosis: randomised controlled trial. BJOG, 2001, 108, 4, p. 396–402.

22. Jacot, FR., Poulin, C., Bilodeau, AP., et al. A five-year experience with second-trimester induced abortions: no increase in complication rate as compared to the first trimester. Am J Obstet Gynecol, 1993, 168, 2, p. 633–637.

23. Zahumensky, J., Zmrhalova, B., Maxova, K., et al. [Abortion induction in IInd trimester]. Ces Gynek, 2008, 73, 2, p. 118–122.

24. Prieto, JA., Eriksen, NL., Blanco, JD. A randomized trial of prophylactic doxycycline for curettage in incomplete abortion. Obstet Gynecol, 1995, 85, 5 Pt 1, p. 692–696.

25. Ramin, KD., Ramin, SM., Hemsell, PG., et al. Prophylactic antibiotics for suction curettage in incomplete abortion. Infect Dis Obstet Gynecol, 1995, 2, 5, p. 213–217.

26. May, W., Gulmezoglu, AM., Ba-Thike, K. Antibiotics for incomplete abortion. Cochrane Database Syst Rev, 2007, 4, p. D1779.

27. Gerber, S., Vial, Y., Hohlfeld, P., Witkin, SS. Detection of Ureaplasma urealyticum in second-trimester amniotic fluid by polymerase chain reaction correlates with subsequent preterm labor and delivery. J Infect Dis, 2003, 187, 3, p. 518–521.

28. Perni, SC., Vardhana, S., Korneeva, I., et al. Mycoplasma hominis and Ureaplasma urealyticum in midtrimester amniotic fluid: association with amniotic fluid cytokine levels and pregnancy outcome. Am J Obstet Gynecol, 2004, 191, 4, p. 1382–1386.

29. Gramellini, D., Fieni, S., Casilla, G., et al. Mid-trimester amniocentesis and antibiotic prophylaxis. Prenat Diagn, 2007, 27, 10, p. 956–959.

30. Giorlandino, C., Cignini, P., Cini, M., et al. Antibiotic prophylaxis before second-trimester genetic amniocentesis (APGA): a single-centre open randomised controlled trial. Prenat Diagn, 2009, 29, 6, p. 606–612.

31. Harger, JH. Cerclage and cervical insufficiency: an evidence-based analysis. Obstet Gynecol, 2002, 100, 6, p. 1313–1327.

32. Charles, D., Edwards, WR. Infectious complications of cervical cerclage. Am J Obstet Gynecol, 1981, 141, 8, p. 1065–1071.

33. Kessler, I., Shoham, Z., Lancet, M., et al. Complications associated with genital colonization in pregnancies with and without cerclage. Int J Gynaecol Obstet, 1988, 27, 3, p. 359–363.

34. Berghella, V., Ludmir, J., Simonazzi, G., Owen, J. Transvaginal cervical cerclage: evidence for perioperative management strategies. Am J Obstet Gynecol, 2013.

35. Goldenberg, RL., Culhane, JF., Iams, JD., Romero, R. Epidemiology and causes of preterm birth. Lancet, 2008, 371, 9606, p. 75–84.

36. Romero, R., Sibai, B., Caritis, S., et al. Antibiotic treatment of preterm labor with intact membranes: a multicenter, randomized, double-blinded, placebo-controlled trial. Am J Obstet Gynecol, 1993, 169, 4, p. 764–774.

37. Kenyon, SL., Taylor, DJ., Tarnow-Mordi, W. Broad-spectrum antibiotics for spontaneous preterm labour: the ORACLE II randomised trial. ORACLE Collaborative Group. Lancet, 2001, 357, 9261, p. 989–994.

38. Kenyon, S., Pike, K., Jones, DR., et al. Childhood outcomes after prescription of antibiotics to pregnant women with spontaneous preterm labour: 7-year follow-up of the ORACLE II trial. Lancet, 2008, 372, 9646, p. 1319–1327.

39. Henderson, E., Love, EJ. Incidence of hospital-acquired infections associated with caesarean section. J Hosp Infect, 1995, 29, 4, p. 245–255.

40. Mangram, AJ., Horan, TC., Pearson, ML., et al. Guideline for Prevention of Surgical Site Infection, 1999. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee. Am J Infect Control, 1999, 27, 2, p. 97–132, 133–134, 96.

41. Acosta, CD., Knight, M. Sepsis and maternal mortality. Curr Opin Obstet Gynecol, 2013, 25(2).

42. Smaill, FM., Gyte, GM. Antibiotic prophylaxis versus no prophylaxis for preventing infection after cesarean section. Cochrane Database Syst Rev, 2010, 1, p. D7482.

43. Chelmow, D., Hennesy, M., Evantash, EG. Prophylactic antibiotics for non-laboring patients with intact membranes undergoing cesarean delivery: an economic analysis. Am J Obstet Gynecol, 2004, 191, 5, p. 1661–1665.

44. Sullivan, SA., Smith, T., Chang, E., et al. Administration of cefazolin prior to skin incision is superior to cefazolin at cord clamping in preventing postcesarean infectious morbidity: a randomized, controlled trial. Am J Obstet Gynecol, 2007, 196, 5, p. 451–455.

45. Baaqeel, H., Baaqeel, R. Timing of administration of prophylactic antibiotics for caesarean section: a systematic review and meta-analysis. BJOG, 2012.

46. Hopkins, L., Smaill, FM. WITHDRAWN: Antibiotic prophylaxis regimens and drugs for cesarean section. Cochrane Database Syst Rev, 2012, 1, p. D1136.

47. Taylor, LK., Simpson, JM., Roberts, CL., et al. Risk of complications in a second pregnancy following caesarean section in the first pregnancy: a population-based study. Med J Aust, 2005, 183, 10, p. 515–519.

48. Chongsomchai, C., Lumbiganon, P., Laopaiboon, M. Prophylactic antibiotics for manual removal of retained placenta in vaginal birth. Cochrane Database Syst Rev, 2006, 2, p. D4904.

49. Clifford, V., Daley, A. Antibiotic prophylaxis in obstetric and gynaecological procedures: a review. Aust N Z J Obstet Gynaecol, 2012, 52, 5, p. 412–419.

50. Ely, JW., Rijhsinghani, A., Bowdler, NC., Dawson, JD. The association between manual removal of the placenta and postpartum endometritis following vaginal delivery. Obstet Gynecol, 1995, 86, 6, p. 1002–1006.

51. Andrews, V., Sultan, AH., Thakar, R., Jones, PW. Occult anal sphincter injuries – myth or reality? BJOG, 2006, 113, 2, p. 195–200.

52. Zahumensky, J., Menzlova, E., Korbel, M., et al. Classification and management of extensive obstetric perineal injuries in the Czech and Slovak Republics. Int J Gynaecol Obstet, 2010, 110, 3, p. 252–256.

53. Duggal, N., Mercado, C., Daniels, K., et al. Antibiotic prophylaxis for prevention of postpartum perineal wound complications: a randomized controlled trial. Obstet Gynecol, 2008, 111, 6, p. 1268–1273.

54. Buppasiri, P., Lumbiganon, P., Thinkhamrop, J., Thinkhamrop, B. Antibiotic prophylaxis for third- and fourth-degree perineal tear during vaginal birth. Cochrane Database Syst Rev, 2010, 11, p. D5125.

55. Perz, JF., Armstrong, GL., Farrington, LA., et al. The contributions of hepatitis B virus and hepatitis C virus infections to cirrhosis and primary liver cancer worldwide. J Hepatol, 2006, 45, 4, p. 529–538.

56. Mast, EE., Margolis, HS., Fiore, AE., et al. A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP) part 1: immunization of infants, children, and adolescents. MMWR Recomm Rep, 2005, 54, RR–16, p. 1–31.

57. Piratvisuth, T. Optimal management of HBV infection during pregnancy. Liver Int, 2013, 33 Suppl 1, p. 188–194.

58. Shi, Z., Yang, Y., Ma, L., et al. Lamivudine in late pregnancy to interrupt in utero transmission of hepatitis B virus: a systematic review and meta-analysis. Obstet Gynecol, 2010, 116, 1, p. 147–159.

59. Wong, VC., Ip, HM., Reesink, HW., et al. Prevention of the HBsAg carrier state in newborn infants of mothers who are chronic carriers of HBsAg and HBeAg by administration of hepatitis-B vaccine and hepatitis-B immunoglobulin. Double-blind randomised placebo-controlled study. Lancet, 1984, 1, 8383, p. 921–926.

60. Nayeri, UA., Werner, EF., Han, CS., et al. Antenatal lamivudine to reduce perinatal hepatitis B transmission: a cost-effectiveness analysis. Am J Obstet Gynecol, 2012, 207, 3, p. 231.

61. Brown, ZA., Benedetti, J., Ashley, R., et al. Neonatal herpes simplex virus infection in relation to asymptomatic maternal infection at the time of labor. N Engl J Med, 1991, 324, 18, p. 1247–1252.

62. Hollier, LM., Wendel, GD. Third trimester antiviral prophylaxis for preventing maternal genital herpes simplex virus (HSV) recurrences and neonatal infection. Cochrane Database Syst Rev, 2008, 1, p. D4946.

63. Scott, LL., Alexander, J. Cost-effectiveness of acyclovir suppression to prevent recurrent genital herpes in term pregnancy. Am J Perinatol, 1998, 15, 1, p. 57–62.

64. Gardella, C., Brown, Z. Prevention of neonatal herpes. BJOG, 2011, 118, 2, p. 187–192.

65. Davies, GA., Maxwell, C., McLeod, L., et al. Obesity in pregnancy. J Obstet Gynaecol Can, 2010, 32, 2, p. 165–173.

66. McLean, M., Hines, R., Polinkovsky, M., et al. Type of skin incision and wound complications in the obese parturient. Am J Perinatol, 2012, 29, 4, p. 301–306.

67. Gordon, SM. Antibiotic prophylaxis against postoperative wound infections. Cleve Clin J Med, 2006, 73 Suppl 1, p. S42–45.

68. Khan, FS., Weiss, ME. Skin testing for beta-lactam antibiotics: impact of the availability of a major determinant. Curr Allergy Asthma Rep, 2013, 13, 1, p. 64–71.

69. Simons, FE., Schatz, M. Anaphylaxis during pregnancy.J Allergy Clin Immunol, 2012, 130, 3, p. 597–606.

70. Apter, AJ., Kinman, JL., Bilker, WB., et al. Is there cross-reactivity between penicillins and cephalosporins? Am J Med, 2006, 119, 4, p. 311–354.

71. Miranda, A., Blanca, M., Vega, JM., et al. Cross-reactivity between a penicillin and a cephalosporin with the same side chain. J Allergy Clin Immunol, 1996, 98, 3, p. 671–677.

72. Romano, A., Gaeta, F., Valluzzi, RL., et al. IgE-mediated hypersensitivity to cephalosporins: cross-reactivity and tolerability of penicillins, monobactams, and carbapenems. J Allergy Clin Immunol, 2010, 126, 5, p. 994–999.