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Sammanfattning

Background. The frequency of caesarean sections is increasing. Infection in operation wounds and/or underlying spaces and organs is a common complication. In Veileder I fødselshjelp [Clinical Guidelines in Obstetrics], 2008, antibiotic prophylaxis is recommended in the form of single dose ampicillin or first generation cephalosporins in connection with acute caesarean sections and under special conditions such as prolonged operations. We wanted to find out whether Norwegian maternity departments follow these recommendations. Material and method. All head senior consultants at maternity departments that carried out more than one caesarean section in 2008 were invited to take part in a survey of the department’s written guidelines for use of antibiotic prophylaxis in connection with caesarean section. The extent to which the guidelines were followed was evaluated using data from the Norwegian Surveillance System for Hospital-Associated Infections (NOIS). Results. 38 of the 42 maternity departments in the survey had written guidelines for antibiotic prophylaxis. Four of these departments gave prophylaxis for all caesarean sections, one only when indicated, and 33 gave prophylaxis in connection with acute caesareans. The guidelines varied with respect to choice of medicinal product and time of administration. At those maternity departments where the written guidelines recommended use of antibiotic prophylaxis with all caesareans, this recommendation was complied with. When the guidelines recommended prophylaxis only in connection with acute operations, there was agreement between practice and the guidelines for between 71 - and 97 - of the patients in the department. Interpretation. The majority of Norwegian maternity departments have written guidelines for the use of antibiotic prophylaxis in connection with caesarean section. The contents of the guidelines varied substantially, but were largely in agreement with current Norwegian recommendations.

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