Full Text Available
Note: Clicking the button above will open the full text document at the original institutional repository in a new window.
Retrospective audit on outcomes of post caesarean section sepsis after additional azithromycin to the standard antibiotic at Tygerberg hospital, Cape Town
Thesis (MSc)--Stellenbosch University, 2023.
Saved in:
| Main Authors: | , , |
|---|---|
| Other Authors: | |
| Format: | Thesis |
| Language: | en_ZA en_ZA |
| Published: |
Stellenbosch : Stellenbosch University
2023
|
| Subjects: | |
| Tags: |
No Tags, Be the first to tag this record!
|
| _version_ | 1867613973862416384 |
|---|---|
| access_status_str | Open Access |
| author | Matabata, Thembani Mbungu, Nomaphelo Singini, Isaac |
| author2 | Gebhardt, Gabriel Stefanus |
| author_browse | Gebhardt, Gabriel Stefanus Matabata, Thembani Mbungu, Nomaphelo Singini, Isaac |
| author_facet | Gebhardt, Gabriel Stefanus Matabata, Thembani Mbungu, Nomaphelo Singini, Isaac |
| author_sort | Matabata, Thembani |
| collection | Thesis |
| dc_rights_str_mv | Stellenbosch University, |
| description | Thesis (MSc)--Stellenbosch University, 2023. |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/128832 |
| institution | Stellenbosch University (South Africa) |
| language | en_ZA en_ZA |
| last_indexed | 2026-06-10T12:44:39.798Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2023 |
| publishDateRange | 2023 |
| publishDateSort | 2023 |
| publisher | Stellenbosch : Stellenbosch University |
| publisherStr | Stellenbosch : Stellenbosch University |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/128832 Retrospective audit on outcomes of post caesarean section sepsis after additional azithromycin to the standard antibiotic at Tygerberg hospital, Cape Town Matabata, Thembani Mbungu, Nomaphelo Singini, Isaac Gebhardt, Gabriel Stefanus Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. Obstetrics and Gynaecology. Cesarean section -- Cape Town (South Africa) Obstetrics – Surgery -- Cape Town (South Africa) Septicemia -- Cape Town (South Africa) Azithromycin -- Cape Town (South Africa) Pregnant women – Surgery – Complications -- Cape Town (South Africa) Thesis (MSc)--Stellenbosch University, 2023. ENGLISH ABSTRACT: Background Surgical site infections (SSI) and endometritis are important causes of post caesarean delivery (CD) morbidity and mortality. They lead to prolonged hospital stay and increase in hospital expenditure. The global rate of SSI is 3-15% with the change in incidence being attributed to changes in population traits, risk factors, perioperative practices and time taken from the procedure. There is currently little clinical data on the incidence of post CD in the South African setting. The commonest organisms associated are Staphylococcus aureus, E. coli, Pseudomonas, Proteus mirabilis and Mycoplasma species. Some of the identifiable risk factors are prolonged labour, emergency CD, multiple vaginal examinations during labour, diabetes mellitus or high Body Mass Index (BMI). With the use of the standard antibiotic prophylaxis, the incidence of post CD sepsis remains high. With dual antibiotic prophylaxis (azithromycin 500mg IV in addition to the standard cephazolin) there is a 60% reduction in post CD sepsis with no adverse neonatal outcomes. Single agent pre-operative prophylaxis with a first-generation cephalosporin (e.g. cefazolin) was the standard of care during 2017, when a retrospective folder review showed a cumulative incidence for post-CS sepsis to be 4.69%. Dual prophylaxis became the standard of care during 2019 with its inclusion in the National Essential Medicine List. This was introduced at Tygerberg Hospital in September 2020. Aim To perform an audit of post caesarean section sepsis after implementation of the additional azithromycin to standard antibiotic protocol at Tygerberg hospital, Cape Town; to monitor adherence to this new protocol as well as to determine the incidence of post-CD sepsis. Methods 3 | Page A retrospective study was conducted on all pregnant women undergoing CD at Tygerberg hospital in from 01 September 2021- 30 November 2021. Records of the cases of the patients were retrieved from the Electronic Content Management (ECM) and followed up to 30 days after delivery to determine the rate of post-CD sepsis. Results A total of 457 records were audited, with 16 women identified with post CD sepsis (a hospital rate of 3.5%). This was 18% lower than the rate reported prior to dual prophylaxis (4.69%). The risk factors identified to be significantly associated with post CD sepsis were number of vaginal examinations >5 (p = 0.007), duration of active labour (p = 0.011), labour mechanism (p = 0.009) and noticeable intra-operative findings including difficult haemostasis and adhesiolysis (p= 0.003). Conclusion Addition of azithromycin to the standard antibiotic reduces the rate of post CD sepsis. Multiple vaginal examinations, duration of active labour, emergency CD and specific intraoperative findings were identifiable risk factors for post CD sepsis. AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar. Masters 2023-11-27T06:52:11Z 2024-01-08T12:45:31Z 2023-11-27T06:52:11Z 2024-01-08T12:45:31Z 2023-12 Thesis https://scholar.sun.ac.za/handle/10019.1/128832 en_ZA en_ZA Stellenbosch University, 21 pages application/pdf Stellenbosch : Stellenbosch University |
| spellingShingle | Cesarean section -- Cape Town (South Africa) Obstetrics – Surgery -- Cape Town (South Africa) Septicemia -- Cape Town (South Africa) Azithromycin -- Cape Town (South Africa) Pregnant women – Surgery – Complications -- Cape Town (South Africa) Matabata, Thembani Mbungu, Nomaphelo Singini, Isaac Retrospective audit on outcomes of post caesarean section sepsis after additional azithromycin to the standard antibiotic at Tygerberg hospital, Cape Town |
| title | Retrospective audit on outcomes of post caesarean section sepsis after additional azithromycin to the standard antibiotic at Tygerberg hospital, Cape Town |
| title_full | Retrospective audit on outcomes of post caesarean section sepsis after additional azithromycin to the standard antibiotic at Tygerberg hospital, Cape Town |
| title_fullStr | Retrospective audit on outcomes of post caesarean section sepsis after additional azithromycin to the standard antibiotic at Tygerberg hospital, Cape Town |
| title_full_unstemmed | Retrospective audit on outcomes of post caesarean section sepsis after additional azithromycin to the standard antibiotic at Tygerberg hospital, Cape Town |
| title_short | Retrospective audit on outcomes of post caesarean section sepsis after additional azithromycin to the standard antibiotic at Tygerberg hospital, Cape Town |
| title_sort | retrospective audit on outcomes of post caesarean section sepsis after additional azithromycin to the standard antibiotic at tygerberg hospital cape town |
| topic | Cesarean section -- Cape Town (South Africa) Obstetrics – Surgery -- Cape Town (South Africa) Septicemia -- Cape Town (South Africa) Azithromycin -- Cape Town (South Africa) Pregnant women – Surgery – Complications -- Cape Town (South Africa) |
| url | https://scholar.sun.ac.za/handle/10019.1/128832 |
| work_keys_str_mv | AT matabatathembani retrospectiveauditonoutcomesofpostcaesareansectionsepsisafteradditionalazithromycintothestandardantibioticattygerberghospitalcapetown AT mbungunomaphelo retrospectiveauditonoutcomesofpostcaesareansectionsepsisafteradditionalazithromycintothestandardantibioticattygerberghospitalcapetown AT singiniisaac retrospectiveauditonoutcomesofpostcaesareansectionsepsisafteradditionalazithromycintothestandardantibioticattygerberghospitalcapetown |