Post-Cesarean Antibiotics Reduce Risk for Surgical Site Infections in Obese Women

By Amy Orciari Herman

Edited by David G. Fairchild, MD, MPH, and Lorenzo Di Francesco, MD, FACP, FHM

Obese women who receive antibiotics after cesarean delivery have a reduced risk for surgical site infections, according to a single-center study in JAMA.

Some 400 women with a prepregnancy body-mass index of 30 or higher who received intravenous cefazolin before C-section were randomized to receive oral cephalexin plus metronidazole or matching placebo for 48 hours after surgery. Incidence of the primary outcome — a surgical site infection within 30 days after delivery — was significantly lower in the antibiotic versus placebo group (6% vs. 15%). Treatment wasn't associated with any serious adverse events.

The researchers calculated that 12 women would need to be treated to prevent one post-C-section surgical site infection in this patient population.

Editorialists call for more research "to determine if there are specific subpopulations within this group to whom the benefit is limited to avoid unnecessary antibiotic exposure and its associated risks among those unlikely to benefit."