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Poster Session 1

(167) Comparison of Antibiotic Regimens for Preventing Infectious Complications Following Elective Cesarean Delivery

Thursday, January 30, 2025
10:30 AM – 12:30 PM  

    Submitting Author and Presenting Author(s)

  • Daniel Gabbai, MD, MPH

    Lis Hospital for Women’s Health, Tel Aviv Sourasky Medical Center
    Tel-Aviv, Tel Aviv, Israel

    • Coauthor(s)

  • Itamar Gilboa, MD

    Lis Hospital for Women’s Health, Tel Aviv Sourasky Medical Center
    Tel-Aviv, Tel Aviv, Israel

  • AL

    Anat Lavie, MD

    Tel Aviv Sourasky Medical Center
    Tel Aviv Sourasky Medical Center, Tel Aviv, Israel

  • YY

    Yariv Yogev, MD

    Lis Maternity Hospital, Sourasky Medical Center, Tel Aviv University
    Tel Aviv Sourasky Medical Center, Tel Aviv, Israel

  • Emmanuel Attali, MD

    Lis Hospital for Women’s Health, Tel Aviv Sourasky Medical Center
    Tel-Aviv, Tel Aviv, Israel

Objective:

To compare the efficacy of two antibiotic regimens (Cefazolin versus Clindamycin + Gentamicin) for preventing infectious complications following elective cesarean delivery.



Study Design:

A retrospective cohort study was conducted at a single tertiary university-affiliated medical center (2012 and 2023). All women who underwent an elective cesarean delivery were included and divided into two groups: the standard regimen group (control) were treated by Cefazolin (2 grams) and the study group, comprising of women with cephalosporin allergy were treated by a Clindamycin (900 mg) + Gentamicin (5 mg/kg) regimen. Maternal and neonatal outcomes were collected and analyzed.

The primary outcome was the need for antibiotics admission for the mother during hospitalization and the secondary outcome was the need for readmission due to obstetric or gynecological complications.

Results:


  1. Out of 145,883 deliveries, 19,977 (13.5%) were elective cesarean deliveries.

  2. Cefazolin was administered to 11,586 women (92%), while 1,010 women (8%) received Clindamycin + Gentamicin.

  3. The control group (Cefazolin only) had a lower incidence of infectious complications compared to the study group. [Table 1].

  4. Primary outcome (the need for antibiotic treatment during hospitalization) was 35.4% vs. 5.7% in the control group (p< 0.001) and rate of re-admission was 3.2% vs. 1.9% in the control group (p=0.008)

  5. Multivariate logistic regression analysis revealed that women in the alternative regimen group (Clindamycin + Gentamicin) had higher odds for  antibiotic treatment during hospitalization (aOR 13.04, 95% CI 5.3-31.6, p< 0.001), and readmission (aOR 1.92, 95% CI 1.27-2.94, p=0.002). [Table 2]



Conclusion:

The antibiotic regimen of Cefazolin is more effective in preventing infectious complications following elective cesarean delivery compared to the combination of Clindamycin + Gentamicin regimen. The study highlights the need for careful assessment of beta-lactam allergies to ensure appropriate prophylactic choices.