Applying surgical antimicrobial standards in cesarean deliveries

Antimicrobial prophylaxis practices are critical to surgical site infection risk-reduction strategies. Included in these practices is antibiotic redosing following prolonged procedures or after large blood losses. Guidelines have been published by several professional associations, with most endorsing repeat antibiotic administration after an estimated blood loss of 1500 mL or following 2 half-lives of the select agent. These conventions have been widely adopted by surgeons with the exception of obstetricians at the time of cesarean delivery. This Viewpoint explores existing guidelines, reviews the data for these recommendations, and questions the tradition of abstinence from redosing in cesarean deliveries despite the burden of infection in this cohort.