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Antibiotic prophylaxis to lower risk for surgical site infection and postoperative morbidity has long been a tenet of obstetric and gynecologic surgery. Prophylaxis at cesarean delivery typically has been administered after umbilical cord clamping to minimize the infant's exposure to antimicrobials, presumably to lower risk for antibiotic resistance and to maintain diagnostic accuracy of neonatal evaluations for sepsis.
The American College of Obstetricians and Gynecologists (ACOG) has released a new Committee Opinion as a result of two recent trials in which timing of antimicrobial prophylaxis at cesarean delivery was evaluated. Investigators randomized women to receive cefazolin before or at time of skin incision versus at time of cord cla…