Trial Outcomes & Findings for Timing of Antibiotic Prophylaxis for Cesarean Deliveries (NCT NCT00805545)

NCT ID: NCT00805545

Last Updated: 2012-04-16

Results Overview

In non-pregnant patients having certain types of surgery with a high risk of infection, prophylactic antibiotics are routinely administered before the surgical procedure begins to ensure that a high level of antibiotic is present in tissue prior to the time that maximum bacterial contamination occurs. However, there has been concern about exposing the fetus in utero to antibiotics. The question to be addressed was whether preoperative antibiotics (as opposed to antibiotics administered after clamping of the umbilical cord) benefitted the mother without increasing risk for the baby.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

400 participants

Primary outcome timeframe

Patients were followed from the time of surgery until 6 weeks postpartum.

Results posted on

2012-04-16

Participant Flow

Recruitment was from November 1, 2008 through November 30, 2009 on the Labor and Delivery unit at the University of Florida.

We used computer generated random numbers to assign patients to the two groups. Patients were excluded from the study if they were allergic to either of the study drugs or if they had evidence of infection prior to surgery.

Participant milestones

Participant milestones
Measure
Preoperative Antibiotics
Group of patients that will receive antibiotics 30-60 minutes prior to incision
Post Cord-clamping Antibiotics
Group of patients that will receive antibiotics immediately after clamping the umbilical cord
Overall Study
STARTED
200
200
Overall Study
COMPLETED
194
197
Overall Study
NOT COMPLETED
6
3

Reasons for withdrawal

Reasons for withdrawal
Measure
Preoperative Antibiotics
Group of patients that will receive antibiotics 30-60 minutes prior to incision
Post Cord-clamping Antibiotics
Group of patients that will receive antibiotics immediately after clamping the umbilical cord
Overall Study
Protocol Violation
3
1

Baseline Characteristics

Timing of Antibiotic Prophylaxis for Cesarean Deliveries

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Preoperative Antibiotics
n=200 Participants
Group of patients that will receive antibiotics 30-60 minutes prior to incision
Post Cord-clamping Antibiotics
n=200 Participants
Group of patients that will receive antibiotics immediately after clamping the umbilical cord
Total
n=400 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=39 Participants
0 Participants
n=41 Participants
0 Participants
n=35 Participants
Age, Categorical
Between 18 and 65 years
200 Participants
n=39 Participants
200 Participants
n=41 Participants
400 Participants
n=35 Participants
Age, Categorical
>=65 years
0 Participants
n=39 Participants
0 Participants
n=41 Participants
0 Participants
n=35 Participants
Age Continuous
28.04 years
STANDARD_DEVIATION 6.6 • n=39 Participants
28.9 years
STANDARD_DEVIATION 5.8 • n=41 Participants
28.9 years
STANDARD_DEVIATION 6.2 • n=35 Participants
Sex: Female, Male
Female
200 Participants
n=39 Participants
200 Participants
n=41 Participants
400 Participants
n=35 Participants
Sex: Female, Male
Male
0 Participants
n=39 Participants
0 Participants
n=41 Participants
0 Participants
n=35 Participants
Region of Enrollment
United States
200 participants
n=39 Participants
200 participants
n=41 Participants
400 participants
n=35 Participants

PRIMARY outcome

Timeframe: Patients were followed from the time of surgery until 6 weeks postpartum.

Population: All 194 patients who received preoperative antibiotics and who completed the study were analyzed. All 197 patients who received post-cord clamping antibiotics and who completed the study were analyzed.

In non-pregnant patients having certain types of surgery with a high risk of infection, prophylactic antibiotics are routinely administered before the surgical procedure begins to ensure that a high level of antibiotic is present in tissue prior to the time that maximum bacterial contamination occurs. However, there has been concern about exposing the fetus in utero to antibiotics. The question to be addressed was whether preoperative antibiotics (as opposed to antibiotics administered after clamping of the umbilical cord) benefitted the mother without increasing risk for the baby.

Outcome measures

Outcome measures
Measure
Preoperative Antibiotics
n=194 Participants
Group of patients that will receive antibiotics 30-60 minutes prior to incision
Post Cord-clamping Antibiotics
n=197 Participants
Group of patients that will receive antibiotics immediately after clamping the umbilical cord
Endometritis and Wound Infection
6 patients infected
Interval 0.142 to 7.28
4 patients infected
Interval 0.372 to 11.34

Adverse Events

Preoperative Antibiotics

Serious events: 0 serious events
Other events: 6 other events
Deaths: 0 deaths

Post Cord-clamping Antibiotics

Serious events: 0 serious events
Other events: 4 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Preoperative Antibiotics
n=200 participants at risk
Group of patients that will receive antibiotics 30-60 minutes prior to incision
Post Cord-clamping Antibiotics
n=200 participants at risk
Group of patients that will receive antibiotics immediately after clamping the umbilical cord
Pregnancy, puerperium and perinatal conditions
Endometritis and wound infection
3.0%
6/200 • Number of events 6 • 1 year
We evaluated the frequency of endometritis and wound infection in study patients. We also assessed patients for possible adverse effects related to administration of prophylatic antibiotics.
2.0%
4/200 • Number of events 4 • 1 year
We evaluated the frequency of endometritis and wound infection in study patients. We also assessed patients for possible adverse effects related to administration of prophylatic antibiotics.

Additional Information

Patrick Duff, M.D.

University of Florida

Phone: 352 273 7673

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place