Successful control program to implement the appropriate antibiotic prophylaxis for cesarean section

  • Silvia Nunes Szente Fonseca Department of Infection Control
  • Maria Helena Sofia Department of Infection Control
  • Silvana Quintana Department of Infection Control
  • Fernanda Dos Santos Nogueira Department of Infection Control
  • Anna S. Levin University of São Paulo; Department of Infectious Diseases; Infection Control Department
Keywords: Antimicrobial prophylaxis, Cesarean section, Compliance, Cefazolin, Surgical site infection


OBJECTIVE: Describe implementation of a successful program to reduce doses (cefazolin 2 to 1 g) used for antimicrobial prophylaxis. METHODS: Evaluation of an intervention program to reduce prophylactic antimicrobial doses. The intervention included weekly staff discussions, automatic dispensation of 1g-vial of cefazolin by the pharmacy unless expressly requested by surgeon and increase in post-discharge surveillance as a strategy to reassure surgeons of the safety of the reduction. In the pre and post intervention periods, a prospective study of antimicrobial consumption and surgical site infections were measured. RESULTS: There were 5,164 and 5,204 deliveries in 2001-2002 and 2003-2004, respectively; 1,524 (29.5%) and 1,363 (26%) were cesarean sections. There was a 45% decrease in cefazolin vials used on average per cesarean section (2.29 to 1.25). Patients evaluated increased from 16% to 67% and the SSI rates in both periods were 3.34% to 2.42%, respectively. CONCLUSION: An ample intervention, including administrative and educational measures, led to high compliance with dose reduction and saved more than US$4,000 in cefazolin, considered important because government reimbursement in Brazil for cesarean section is $80.


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How to Cite
Fonseca, S., Sofia, M., Quintana, S., Nogueira, F., & Levin, A. (2008). Successful control program to implement the appropriate antibiotic prophylaxis for cesarean section . Revista Do Instituto De Medicina Tropical De São Paulo, 50(2), 79-82. Retrieved from