The impact of low-dose versus high-dose antibiotic prophylaxis regimens on surgical site infection rates after cesarean delivery

Mauricio La Rosa, Chasey Omere, Tiffany Redfern, Mahmoud Abdelwahab, Nicholas Spencer, Josephine Villarreal, Gayle Olson, George R. Saade, Antonio F. Saad

Research output: Contribution to journalArticle


Objective: The objective of this study was to determine if high-dose antibiotic prophylaxis with cefazolin decreases the risk of surgical site infection (SSI) after a cesarean delivery. Methods: We performed a retrospective cohort study of women who underwent a cesarean section. Two preoperative antibiotic regimens were compared: low dose versus high dose. The primary outcome was SSI. A sample size of 343 patients per group was calculated for a 50% reduction in risk for SSI. Results: Seven hundred and thirty women were included with an incidence of SSI of 5%. Women who received the high-dose antibiotic regimen had lower rates of risk factors for SSI. The only exception was skin incision closure with staples. The rate of SSI did not differ between the low-dose and high-dose groups, even after adjusting for confounding variables [aOR 1.78, 95% CI (0.82–3.9)]. Conclusions: Higher doses of antibiotic prophylaxis did not decrease the rates of SSI after cesarean delivery.

Original languageEnglish (US)
JournalArchives of Gynecology and Obstetrics
StateAccepted/In press - Jan 1 2019



  • Antibiotics
  • Cesarean
  • Infection
  • Pregnancy
  • Prophylaxis
  • Wound

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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