Study shows it is safe to give antibiotics to mothers after umbilical cord clamping in C-sections, to avoid exposure of newborns

April 17, 2020

New research to be presented at the European Congress of Clinical Microbiology and Infectious Diseases (ECCMID)* shows that it is safe to give antibiotics to mothers after umbilical cord clamping in Caesarean section, rather than before, to avoid exposure of the newborn baby to these drugs. The study is by Dr Rami Sommerstein, Bern University Hospital, Bern, Switzerland, and colleagues from Swissnoso, the Swiss National Centre for Infection Control.

The World Health Organization (WHO) recommends** administration of surgical antimicrobial prophylaxis (SAP) in Caesarean section prior to incision to prevent surgical site infections (SSIs), including endometritis, one of the most common types of these infections. However, SAP may disrupt the baby's developing gastrointestinal microbiome if given before umbilical cord clamping. The authors thus studied whether giving antibiotics before or after clamping of the umbilical cord had any effect on the rate of SSIs in the mothers.

The current practice to give antimicrobial prophylaxis before incision was introduced in around 2012, after various evidence was published, and this was when many obstetricians switched to 'before incision' practice. WHO then published guidance in 2015. However, not all hospitals switched to the new practice (in Switzerland or other countries). As a result, it is possible to compare the outcomes of women who were given the antibiotics before incision with those given antibiotics after.

The study used data from the Swissnoso national SSI surveillance system, from 2009 to 2018. The study included mothers from 178 hospitals. The researchers included all Caesarean section patients that were given the SAP agents cefuroxime, cefazolin, amoxicillin/clavulanate or ceftriaxone, either within 60 minutes before incision or after clamping. Data from 30-day post-discharge follow-up was available in 89% of cases, allowing the researchers to assess the association between SAP administration relative to incision and clamping and the SSI rate, using computer models. The data was then adjusted for patient characteristics, procedural variables, and health-care system factors.

A total of 55,901 patients met the criteria: SAP was administered before incision in 26,405 patients (47.2%) and after clamping in 29,496 patients (52.8%). Overall, 846 SSIs were documented, of which 379 (1.6%) occurred before incision and 449 (1.7%) after clamping, with no statistically significant difference between the two methods, proving them to be equally safe. Supplementary and subgroup analyses supported these main results.

The authors conclude: "The results of this large prospective study provide strong evidence that the risk of surgical site infection for the mother in Caesarean section is not increased if antibiotic prophylaxis is given after umbilical cord clamping, compared to before incision. Given the latest research on the potentially detrimental effects of early-life antimicrobial exposure, guidance regarding optimal SAP timing should be re-evaluated."
-end-


European Society of Clinical Microbiology and Infectious Diseases

Related Antibiotics Articles from Brightsurf:

Insights in the search for new antibiotics
A collaborative research team from the University of Oklahoma, the Memorial Sloan Kettering Cancer Center and Merck & Co. published an opinion article in the journal, Nature Chemical Biology, that addresses the gap in the discovery of new antibiotics.

New tricks for old antibiotics
The study published in the journal Immunity reveals that tetracyclines (broad spectre antibiotics), by partially inhibiting cell mitochondria activity, induce a compensatory response on the organism that decreases tissue damage caused during infection.

Benefits, risks seen with antibiotics-first for appendicitis
Antibiotics are a good choice for some patients with appendicitis but not all, according to study results published today in the New England Journal of Medicine.

How antibiotics interact
Understanding bottleneck effects in the translation of bacterial proteins can lead to a more effective combination of antibiotics / study in 'Nature Communications'

Are antivitamins the new antibiotics?
Antibiotics are among the most important discoveries of modern medicine and have saved millions of lives since the discovery of penicillin almost 100 years ago.

Hygiene reduces the need for antibiotics by up to 30%
A new paper published in the American Journal of Infection Control (AJIC), finds improved everyday hygiene practices, such as hand-washing, reduces the risk of common infections by up to 50%, reducing the need for antibiotics, by up to 30%.

Antibiotics: City dwellers and children take the most
City dwellers take more antibiotics than people in rural areas; children and the elderly use them more often than middle-aged people; the use of antibiotics decreases as education increases, but only in rich countries: These are three of the more striking trends identified by researchers of the NRW Forschungskolleg ''One Health and Urban Transformation'' at the University of Bonn.

Metals could be the link to new antibiotics
Compounds containing metals could hold the key to the next generation of antibiotics to combat the growing threat of global antibiotic resistance.

Antibiotics from the sea
The team led by Prof. Christian Jogler of Friedrich Schiller University, Jena, has succeeded in cultivating several dozen marine bacteria in the laboratory -- bacteria that had previously been paid little attention.

Antibiotics not necessary for most toothaches, according to new ADA guideline
The American Dental Association (ADA) announced today a new guideline indicating that in most cases, antibiotics are not recommended for toothaches.

Read More: Antibiotics News and Antibiotics Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.