[Matthias.Maiwald@KKH.COM.SG Subject: Re: LUSCS Preoperative antibiotic prophylaxis In-Reply-To:]

Dear Group,

If LUSCS is referring to Caesarian sections (I am familiar with LSCS), then
I can contribute that we are a very large paediatric and obstetric hospital
and have recently reviewed in our hospital infection control committee the
antibiotic prophylaxis for Caesarian sections.

First, we noticed that there were a few articles that challenged the prior
practice that surgical antibiotic prophylaxis should be given only after
cord clamping. The newer articles found that giving it prior to incision
results in better maternal outcome but has no negative effects on the baby.

Owens SM, Brozanski BS, Meyn LA, Wiesenfeld HC.
Antimicrobial prophylaxis for cesarean delivery before skin incision.
Obstet Gynecol. 2009 Sep;114(3):573-9.

Walsh CA.
Evidence-based cesarean technique.
Curr Opin Obstet Gynecol. 2010 Apr;22(2):110-5.

Lamont RF, Sobel JD, Kusanovic JP, Vaisbuch E, Mazaki-Tovi S, Kim SK,
Uldbjerg N, Romero R.
Current debate on the use of antibiotic prophylaxis for caesarean section.
BJOG. 2011 Jan;118(2):193-201. doi: 10.1111/j.1471-0528.2010.02729.x.

We have now recommended our obstretric teams to implement before incision.
As for other surgery, the ideal timing is 30-60 min before incision.

Substances that we recommend is cefazolin, and in case of allergy,
clindamycin/lincomycin.

Best regards, Matthias.

—
Matthias Maiwald, MD, FRCPA
Consultant in Microbiology
Adj. Assoc. Prof., Natl. Univ. Singapore
Department of Pathology and Laboratory Medicine
KK Women’s and Children’s Hospital
100 Bukit Timah Road
Singapore 229899
Tel. +65 6394 8725 (Office)
Tel. +65 6394 1389 (Laboratory)
Fax +65 6394 1387

“Brown, Saffron
J”
AICALIST@AICALIST.ORG.AU
Sent by: AICA cc
Infexion
Connexion Subject
prophylaxis

30/03/2011 12:27
PM

Please respond to
AICA Infexion
Connexion

Hi Sue
The Therapeutic Guidelines Version 14 – 2010 is the best place to find
recommendations for your review.
Regards
Saffron Brown

Saffron Brown
Clinical Nurse Consultant – Infection Control
Tasmanian Infection Prevention & Control Unit (TIPCU)
Department of Health & Human Services

25 Argyle St
GPO Box 125 Hobart TAS 7001

Of Borrell, Sue

Dear all,

We are currently reviewing our preoperative antibiotic prophylaxis regime
for LUSCS procedures. I would be interested in what agent, dose and timing
is currently being used at your health service.

A copy of your protocol could be send to me directly- email below.

regards
Sue

Sue Borrell
Infection Control Nurse Consultant
Infection Prevention and Healthcare Epidemiology

t 03 9076 1560 e S.Borrell@alfred.org.au
m 0429 806 356

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