Research Day

PROPHYLAXIS THERAPY USING ADJUNCTIVE AZITHROMYCIN WITH STANDARD CEPHALOSPORIN VS. CEPHALOSPORIN ALONE FOR CESAREAN DELIVERY AT BRONSON HOSPITAL

Document Type

Abstract

Date

2021

Abstract

Background: As a result of an increase in surgical procedures, there is also a rise in complications leading to morbidity and mortality. One of the leading indications for surgery is cesarean delivery. Cesarean delivery often leads to post-delivery infections. It is common practice to use a cephalosporin as prophylaxis treatment to reduce the rate of infections. Azithromycin as adjunct therapy to cephalosporin is showing promise in the reduction of post-cesarean infections. This study examines the further reduction impact of infection within a 6-week post-cesarean period.

Methods: This is an on-going retrospective, cohort study being conducted at Bronson Methodist Hospital including 100 patients with > 24 weeks gestation, aged 21 years or older, who have undergone urgent or emergent cesarean delivery for a singleton pregnancy receiving adjunctiveazithromycin 500 mg IV and a standard cephalosporin vs. a standard cephalosporin alone between March 1, 2017 and May 1, 2019.

Preliminary Results: For this study, 60 patient charts were reviewed of which 29 were eliminated. The primary outcome occurred in 3 of 16 (18.8%) patients who received adjunctive azithromycin and 1 of 15 (6.7%) patients who received cephalosporin alone. These results equate to a confidence interval of -0.1 - 0.39 for the azithromycin + cephalosporin group and 0.07 - 0.21 in the cephalosporin alone group.

Conclusion: Currently, the prophylaxis adjunctive use of azithromycin + cephalosporin shows no significant difference from cephalosporin alone for urgent or emergent cesarean delivery at Bronson Methodist. However, with additional data collection, there may be a more convincing yield.

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