Surgical Site Infection Prophylaxis in Obese Women Undergoing Cesarean Delivery

Kayla Peltier, Mercer University College of Pharmacy

The Centers for Disease Control and Prevention (CDC) has reported that in 2015 cesarean deliveries accounted for 32.0% of all reported births. [1] One of the complications of cesarean deliveries is post-cesarean surgical site infection (SSI), and the reported incidence has ranged from 3.7% to 9.8% worldwide. [2] There several risk factors for developing post-cesarean SSI, and obesity is one of the reported factors. [2] This may raise a concern in the United States as the CDC also has reported 38.3% of women who are 20 years of age and older are obese. [3]

While obesity has been identified as an independent risk factor for the development of post-cesarean delivery SSI, limited data is available to attempt to determine the optimal antimicrobial regimen for prophylaxis in obese patients. [4] One gram of cefazolin has been identified as sufficient antimicrobial prophylaxis for post-cesarean SSIs in the general population; however, there are concerns of its efficacy in obese women. [2] Therefore, this study aimed to determine the efficacy of oral cephalexin and oral metronidazole as antimicrobial prophylaxis for post-cesarean SSI in obese women. [4]

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