Analysis of Serum and Tissue Sample to Achieve Adequate Concentrations in Obese Women: 2 vs. 3 grams of Cefazolin during Cesarean Section Premier
Cesarean delivery is the most commonly performed obstetrical surgery in the United States. Infectious morbidity rates, ranging from 7% to 20% and consisting primarily of endomyometritis and wound infection, remain the leading cause of postpartum complications with cesarean delivery. To decrease the postoperative maternal infectious morbidity, antibiotic prophylaxis is administered at cesarean deliveries. A single 1-g dose of cefazolin maintains a therapeutic level of approximately 3-4 hours. If a woman is obese (BMI ≥30 kg/m²), a higher dose of antibiotic prophylactic is recommended. The current protocol on the Labor & Delivery floor of Aurora Sinai Medical Center is to administer 2 grams of antibiotic prophylaxis to patients weighing <120 kg and 3 grams for patients weighing>120 kg. The need to determine whether additional augmented dosages are warranted in obese patients (BMI ≥ 30 kg/m²) is necessary for achieving adequate therapeutic levels in adipose tissue, myometrial tissue, cord blood, and maternal blood.
Determine if women with BMI > 30 kg/m2 undergoing a cesarean delivery who receive 2 vs. 3 grams of cefazolin achieve adequate serum and tissue concentrations
Women 18 years or older, at term with a singleton fetus, who have a scheduled cesarean delivery and a BMI classification of obese (BMI 30.0-39.9), morbidly obese (BMI 40.0-49.9), or super obese (BMI ≥50).
Expected to start September 2014
Danish S. Siddiqui, MD
Omar Cabrera, MD
Jessica J.F. Kram, MPH
Danielle M. Greer, PhD
Robert Burlage, PhD