Key clinical point: A vaginal cleansing protocol significantly reduced deep surgical-site infections (SSIs) after cesarean in high-risk women, such as women in labor or with ruptured membranes.

Major finding: The rate of SSIs was 22% in the standard care group, 17% in the vaginal cleansing group, and 15% in the vaginal cleansing plus azithromycin group.

Study details: A quality improvement study of the effects of a stepwise implementation of vaginal cleansing and azithromycin to reduce SSIs at cesarean delivery in 1,033 deliveries that qualified for the study by being in labor or with ruptured membranes between 2016 and 2019 at Thomas Jefferson University, Philadelphia.

Disclosures: The study received no outside funding. Dr. Quist-Nelson had no financial conflicts to disclose.