2011-ACOG临床指南120：接生和分娩中预防性使用抗生素.pdfVIP

the american college of obstetricians and gynecologists women ’s health care physicians P RAC T I C E BUL L E T I N clinical management guidelines for obstetrician– gynecologists Number 120, JuNe 2011 (Replaces Committee Opinion Number 445, November 2009 and Committee Opinion Number 421, November 2008) Use of Prophylactic Antibiotics in Labor and Delivery The use of antibiotics to prevent infections during the antepartum, intrapartum, and postpartum periods is distinctly different from the use of antibiotics to treat established infections. For many years, the use of prophylactic antibiot- ics was thought to have few adverse consequences. Concerns about the emergence of resistant strains of common bacteria, in addition to the emergence of strains with increased virulence, have resulted in increased scrutiny of the use of antibiotics, particularly in the hospital setting. In labor and delivery, awareness of the potential adverse effects of resistant bacterial infections on neonates has been growing. Finally, cost is an element to consider in the use and choice of prophylactic agents. The purpose of this Practice Bulletin is to present a review of clinical situations in which prophylactic antibiotics are frequently prescribed and to weigh the evidence supporting the use of antibiotics in these scenarios. Background Resistance Risks of Prophylactic Antibiotics Effective prophylactic antibiotic agents are active against Although the risks