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A primary goal of every surgical team is to minimize risk for postoperative infection, which complicates a substantial percentage of cesarean deliveries (particularly in obese women). To assess the effectiveness of postoperative broad-spectrum antibiotics after cesarean delivery, 404 pregnant women with body-mass index >30 kg/m2 who received standard preoperative prophylaxis (2 gm intravenous cefazolin) were randomized to receive postoperative oral placebo or cephalexin (500 mg) and metronidazole (500 mg) every 8 hours for 6 doses.
Surgical site infection (SSI) occurred within 30 days in 6.4% of women receiving postoperative antibiotics versus 15.4% of those receiving placebo (relative risk, 0.41; P=0.01). Among women with ruptured membranes…