Extended antibiotic prophylaxis for prevention of surgical-site infections in morbidly obese women who undergo combined hysterectomy and medically indicated panniculectomy: a cohort study

Am J Obstet Gynecol. 2010 Mar;202(3):306.e1-9. doi: 10.1016/j.ajog.2010.01.053.

Abstract

Objective: The purpose of this study was to compare surgical-site infection rates in obese women who had extended prophylactic antibiotic (EPA) vs standard prophylactic antibiotic.

Study design: An electronic records-linkage system identified 145 obese women (body mass index, >30 kg/m(2)) who underwent combined hysterectomy and panniculectomy from January 1, 2005, through December 31, 2008. The EPA cohort received standard antibiotics (cefazolin, 2 g) and continued oral antibiotic (ciprofloxacin) until removal of drains. Regression models were used to adjust for known confounders.

Results: The mean age was 56.0 + or - 12.1 years, and mean body mass index was 42.6 + or - 8.4 kg/m(2) (range, 30-86.4 kg/m(2)). The EPA cohort experienced fewer surgical-site infections (6 [5.9%] vs 12 [27.9%]; P < .001; adjusted odds ratio, 0.16; 95% confidence interval, 0.04-0.51; P < .001), had lower probability of incision and drainage (3 [2.9%] vs 5 [11.6%]; P = .05), and required fewer infection-related admissions (5 [4.9%] vs 6 [13.9%]; P = .08).

Conclusion: Extended antibiotic prophylaxis can reduce surgical-site infections in obese women after combined hysterectomy and panniculectomy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Amoxicillin-Potassium Clavulanate Combination / administration & dosage
  • Anti-Bacterial Agents / administration & dosage
  • Antibiotic Prophylaxis / methods*
  • Body Mass Index
  • Cefazolin / administration & dosage
  • Ciprofloxacin / administration & dosage
  • Cohort Studies
  • Drainage
  • Drug Administration Schedule
  • Female
  • Humans
  • Hysterectomy*
  • Middle Aged
  • Obesity, Morbid / complications*
  • Ofloxacin / administration & dosage
  • Retrospective Studies
  • Subcutaneous Fat, Abdominal / surgery*
  • Surgical Wound Infection / epidemiology
  • Surgical Wound Infection / microbiology
  • Surgical Wound Infection / prevention & control*

Substances

  • Anti-Bacterial Agents
  • Ciprofloxacin
  • Amoxicillin-Potassium Clavulanate Combination
  • Ofloxacin
  • Cefazolin