To Optimize Antibiotic Choice at Cesarean Delivery, Obtain an Accurate History of β-Lactam Allergy

Prophylactic antibiotics are recommended prior to skin incision at cesarean delivery; however, the first-line choice, cefazolin, should not be given to women who are allergic to this antibiotic. The American College of Obstetricians and Gynecologists (ACOG) recommends that such women receive clindamycin and gentamicin (Obstet Gynecol 2018; 132:e103). To examine whether a composite outcome (including cellulitis, endometritis, deep wound infection, abscess, and sepsis) differed by antibiotic choice, investigators examined records of >6000 cesarean deliveries from 2012 through 2017 at one institution. Ninety-four percent of women received cefazolin, 4% received recommended alternative antibiotics (clindamycin and gentamicin), and 2% received o…