Prophylactic use of antibiotics for nonlaboring patients undergoing cesarean delivery with intact membranes: A meta-analysis
Prophylactic use of antibiotics for nonlaboring patients undergoing cesarean delivery with intact membranes: A meta-analysis
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DOI：
10.1067/mob.2001.111303
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发表时间：
2001-03-01
影响因子：
9.8
通讯作者：
Huang, E
中科院分区：
文献类型：
--
作者：
Chelmow, D;Ruehli, MS;Huang, E
目的：我们进行了一项荟萃分析，以检查抗生素预防在未分娩的剖宫产妇女中预防术后感染的作用。研究设计：使用MEDLINE进行计算机文献检索。如果研究包含了在没有分娩和胎膜破裂的情况下进行剖宫产的患者的数据，则纳入研究。只纳入了安慰剂对照组的随机试验。结果：共发现7项研究。抗生素的使用降低了所有感染结果的风险。当汇总4项研究的结果时，预防性抗生素的使用与术后发热的显著降低相关（相对风险，0.25；95%可信区间，0.14-0.44）。在4项研究中，子宫内膜炎也有类似的减少（相对危险度，0.05；95%可信区间，0.01-0.38）。两项研究报告了伤口感染，并显示出保护作用的趋势（相对风险，0.59；95%可信区间，0.24-1.45）。结论：即使在风险最低的人群中，预防性使用抗生素也能降低剖宫产术后感染并发症的发生风险。
OBJECTIVE: We performed a meta-analysis to examine the role of antibiotic prophylaxis in preventing postoperative infections among nonlaboring women undergoing cesarean delivery with intact membranes.STUDY DESIGN: A computerized literature search was performed with MEDLINE. Studies were included if they contained data on patients undergoing cesarean delivery in the absence of labor and ruptured membranes. Only randomized trials with a placebo control group were included.RESULTS: Seven studies were found. Use of antibiotics decreased the risk of all infectious outcomes reported. When the results of 4 studies were pooled, prophylactic antibiotic use was associated with a significant reduction in postoperative fever (relative risk, 0.25; 95% confidence interval, 0.14-0.44). A similar reduction was noted for endometritis in 4 studies (relative risk, 0.05; 95% confidence interval, 0.01-0.38). Two studies reported on wound infection and showed a trend toward a protective effect (relative risk, 0.59; 95% confidence interval, 0.24-1.45).CONCLUSION: The prophylactic use of antibiotics reduces the risk of postoperative infectious complications after cesarean delivery even in the population at lowest risk.