ABSTRACT
Objective
The purpose of this quality improvement study was to determine the effect of adding
azithromycin to standard antibiotic prophylaxis on the rates surgical site infection
(SSI) in women undergoing both elective and non-elective cesarean deliveries at our
centre.
Methods
A before-and-after quality improvement study was conducted at the Regina General Hospital
in Regina, Saskatchewan. Data collected from 989 women who had a caesarean delivery
between June 1, 2016 and June 30, 2017 were compared with those from 1033 women who
had a caesarean delivery between August 1, 2017 and July 31, 2018, after the introduction
of adjunctive azithromycin prophylaxis. The primary outcome measure was the change
in the incidence of SSI up to 30 days following surgery. Secondary outcome measures
included timing of azithromycin prophylaxis and the number of women who did not receive
azithromycin.
Results
Surgical site infection rates decreased from 3.5% to 2.9% after adjunctive azithromycin
prophylaxis was introduced. The absolute reduction in SSIs of 0.6% was not statistically
significant (P = 0.42). There were no differences in SSI rates between the elective and non-elective
subgroups.
Conclusion
Adding azithromycin to the standard antibiotic prophylaxis for cesarean delivery showed
no statistically significant reduction in SSI rates in a population with low baseline
rates of SSI.
RÉSUMÉ
Objectif
L'objectif de cette étude d'amélioration de la qualité était de déterminer l'effet
de l'ajout d'azithromycine au protocole standard d'antibioprophylaxie sur le taux
d'infection du champ opératoire (ICO) chez les femmes subissant une césarienne planifiée
ou non planifiée dans notre centre de soins.
Méthodologie
Une étude sur l'amélioration de la qualité pré- et post-intervention a été menée à
l'Hôpital général de Regina, en Saskatchewan. Les données recueillies de 989 femmes
ayant subi une césarienne entre le 1er juin 2016 et le 30 juin 2017 ont été comparées à celles de 1 033 femmes ayant subi
une césarienne entre le 1er août 2017 et le 31 juillet 2018, après l'instauration de la prophylaxie adjuvante
par azithromycine. Le critère de jugement principal était la variation de l'incidence
des ICO jusqu’à 30 jours après la césarienne. Les critères de jugement secondaires
comprenaient le moment d'administration de la prophylaxie par azithromycine et le
nombre de femmes qui n'ont pas reçu d'azithromycine.
Résultats
Les taux d'ICO sont passés de 3,5 à 2,9 % après l'instauration de la prophylaxie adjuvante
par azithromycine. La réduction absolue de 0,6 % du taux d'ICO n’était pas statistiquement
significative (P = 0,42). Aucune différence n'a été observée quant au taux d'ICO entre les sous-groupes
de césarienne planifiée et de césarienne non planifiée.
Conclusion
L'ajout d'azithromycine au protocole standard d'antibioprophylaxie pour la césarienne
n'a révélé aucune diminution statistiquement significative du taux d'ISO chez une
population dont le taux initial d'ICO était faible.
Keywords
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Article info
Publication history
Published online: January 04, 2021
Footnotes
Disclosures: The authors declare they have nothing to disclose.
All authors have indicated they meet the journal's requirements for authorship.
Identification
Copyright
© 2021 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.
