Efficacy of Non-Beta-lactam Antibiotics for Prevention of Cesarean Delivery Surgical Site Infections.
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2019-04-30
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Abstract
Objective To examine the association between perioperative Beta ( β ))-lactam versus non- β -lactam antibiotics and cesarean delivery surgical site infection (SSI). Study Design Retrospective cohort of women undergoing cesarean delivery from January 1 to December 31, 2014. All women undergoing cesarean after 34 weeks with a postpartum visit were included. Prevalence of SSI was compared between women receiving β -lactam versus non- β -lactam antibiotics. Bivariate analyses were performed using Pearson's Chi-square, Fisher's exact, or Wilcoxon's rank-sum tests. Logistic regression models were fit controlling for possible confounders. Results Of the 929 women included, 826 (89%) received β -lactam prophylaxis and 103 (11%) received a non- β -lactam. Among the 893 women who reported a non-type I (low risk) allergy, 819 (92%) received β -lactam prophylaxis. SSI occurred in 7% of women who received β -lactam antibiotics versus 15% of women who received a non- β -lactam ( p = 0.004). β -Lactam prophylaxis was associated with lower odds of SSI compared with non- β -lactam antibiotics (odds ratio [OR] = 0.43; 95% confidence interval [CI] = 0.22-0.83; p = 0.01) after controlling for chorioamnionitis in labor, postlabor cesarean, endometritis, tobacco use, and body mass index (BMI). Conclusion β -Lactam perioperative prophylaxis is associated with lower odds of a cesarean delivery surgical site infection compared with non- β -lactam antibiotics.
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Harris, Benjamin S, Maeve K Hopkins, Margaret S Villers, Jeremy M Weber, Carl Pieper, Chad A Grotegut, Geeta K Swamy, Brenna L Hughes, et al. (2019). Efficacy of Non-Beta-lactam Antibiotics for Prevention of Cesarean Delivery Surgical Site Infections. AJP reports, 9(2). pp. e167–e171. 10.1055/s-0039-1685503 Retrieved from https://hdl.handle.net/10161/18965.
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Scholars@Duke
Jeremy Weber
Carl F. Pieper
Analytic Interests.
1) Issues in the Design of Medical Experiments: I explore the use of reliability/generalizability models in experimental design. In addition to incorporation of reliability, I study powering longitudinal trials with multiple outcomes and substantial missing data using Mixed models.
2) Issues in the Analysis of Repeated Measures Designs & Longitudinal Data: Use of Hierarchical Linear Models (HLM) or Mixed Models in modeling trajectories of multiple variables over time (e.g., physical and cognitive functioning and Blood Pressure). My current work involves methodologies in simultaneous estimation of trajectories for multiple variables within and between domains, modeling co-occuring change.
Areas of Substantive interest: (1) Experimental design and analysis in gerontology and geriatrics, and psychiatry,
(2) Multivariate repeated measures designs,
Geeta Krishna Swamy
Geeta Swamy, MD, Haywood Brown, MD Distinguished Professor of Women’s Health, serves as Executive Vice Dean for Clinical Sciences & Research Administration for the Duke University School of Medicine and Associate Vice President for Research for Duke University. In these roles, Dr. Swamy oversees central operations aligned with clinical departments and research centers, facilitating research priorities in collaboration with clinical chairs and vice chairs, and managing research administration and compliance. She works closely with leadership across the Duke Health Integrated Practice (DHIP) and Duke University Health System (DUHS) on areas that intersect with the academic missions. She collaborates with leaders across the Duke University campus to provide a consistent vision for research administration, operations, quality, and accountability. Her responsibilities include overseeing pre- and post-award management for sponsored grants and contracts, human research, research quality, compliance, and integrity, conflict of interest, and other regulatory areas. As a highly accomplished clinician-scientist, Dr. Swamy’s research specializes in perinatal infection, maternal immunization, and complications of pregnancy.
Brenna L Hughes
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