{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T19:33:12Z","timestamp":1768591992565,"version":"3.49.0"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,2,18]],"date-time":"2021-02-18T00:00:00Z","timestamp":1613606400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the effects of a quality improvement initiative regarding the administration of antibiotics at the time of obstetric anal sphincter injury (OASIS) repair.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>At University of Michigan\u2014a tertiary care center in Ann Arbor, MI, USA, we implemented a quality improvement intervention aimed at administering a single dose of broad\u2010spectrum antibiotics at the time of OASIS repair. Best practice recommendations and reminders were presented to the department. Cefazolin plus metronidazole or clindamycin plus gentamycin were the recommended antibiotics. The effects of this intervention were assessed based on a chart review of deliveries between January 4, 2014 and February 13, 2019, which included patient data both pre\u2010initiative and post\u2010initiative to compare the prevalence of antibiotic use at the time of OASIS repair.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Recommended antibiotic use increased from 0.3% (1\/372) pre\u2010initiative to 75.7% (106\/140) post\u2010initiative (\n                      <jats:italic>P\u00a0&lt;\u00a0<\/jats:italic>\n                      0.001), and any antibiotic use increased from 6.5% (24\/372) to 82.9% (116\/140,\n                      <jats:italic>P\u00a0&lt;\u00a0<\/jats:italic>\n                      0.001). The proportion of cases complicated by wound infection\/breakdown decreased by 55% after the quality improvement intervention (3.2% pre\u2010intervention vs 1.4% post\u2010intervention,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.22).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Following a departmental quality improvement intervention aimed at increasing antibiotic administration at the time of OASIS repair, antibiotic use increased 13\u2010fold. Although underpowered to detect a significant difference in wound complications, our study showed a clinically meaningful decrease in wound infection\/breakdown with antibiotic administration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.13623","type":"journal-article","created":{"date-parts":[[2021,1,28]],"date-time":"2021-01-28T18:58:46Z","timestamp":1611860326000},"page":"95-101","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Antibiotic use during repair of obstetrical anal sphincter injury: a quality improvement initiative"],"prefix":"10.1002","volume":"156","author":[{"given":"Caroline K.","family":"Cox","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Pennsylvania Philadelphia PA USA"},{"name":"Department of Obstetrics and Gynecology University of Michigan Ann Arbor MI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meghan D.","family":"Bugosh","sequence":"additional","affiliation":[{"name":"IHA Obstetrics and Gynecology Ann Arbor MI USA"},{"name":"Department of Obstetrics and Gynecology University of Michigan Ann Arbor MI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dee E.","family":"Fenner","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Michigan Ann Arbor MI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roger","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Michigan Ann Arbor MI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolyn W.","family":"Swenson","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Michigan Ann Arbor MI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,2,18]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2000.105403"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2003.09.030"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-200108000-00008"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e318142cdf4"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000833"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31816de8ad"},{"key":"e_1_2_8_8_1","unstructured":"Royal College of Obstetricians and Gynaecologists.The Management of Third\u2010 and Fourth\u2010Degree Perineal Tears. Green\u2010top Guideline No. 29.2015.https:\/\/www.rcog.org.uk\/globalassets\/documents\/guidelines\/gtg\u201029.pdf. Accessed December 1 2017."},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002841"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.03.019"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1089\/sur.2008.9956"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2006.07.030"},{"issue":"12","key":"e_1_2_8_13_1","first-page":"Cd002866","article-title":"Methods of repair for obstetric anal sphincter injury","author":"Fernando RJ","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2014.07.026"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h2750"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2015-004411"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/chp.1340240506"},{"issue":"4","key":"e_1_2_8_18_1","first-page":"CD005470","article-title":"Tailored interventions to address determinants of practice","author":"Baker R","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.12.025"}],"container-title":["International Journal of Gynecology &amp; Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.13623","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ijgo.13623","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.13623","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T13:34:57Z","timestamp":1766496897000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/ijgo.13623"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,18]]},"references-count":18,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,1]]}},"alternative-id":["10.1002\/ijgo.13623"],"URL":"https:\/\/doi.org\/10.1002\/ijgo.13623","archive":["Portico"],"relation":{},"ISSN":["0020-7292","1879-3479"],"issn-type":[{"value":"0020-7292","type":"print"},{"value":"1879-3479","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,18]]},"assertion":[{"value":"2020-06-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-01-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-02-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}