Effect of universal antibiotic prophylaxis on prevalence of surgical site infection after cesarean section

Background/Objectives: Cesarean section (CS) is among the most common surgical procedures worldwide and is associated with a markedly increased risk of postpartum infection, including surgical site infection (SSI). International guidelines recommend routine prophylaxis for all CSs, but in Slovenia, it has traditionally been reserved for high-risk procedures, with limited SSI surveillance data. The aim of this study was to determine the incidence of SSI within 30 days after CS and to evaluate the impact of universal prophylaxis implemented in a regional secondary care teaching hospital. Methods: We conducted a retrospective observational cohort study including all CS performed during 2023 (risk-based-only prophylaxis) and 2024 (universal prophylaxis) at Izola General Hospital, Slovenia. SSI was defined according to ECDC criteria and identified from inpatient and outpatient records up to 30 days postoperatively. Logistic regression was used to assess associations between prophylaxis, clinical variables, and SSI. Results: Among 1055 deliveries (208 CS