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Quality and safety in the literature: November 2019
  1. Ashwin Gupta1,2,
  2. Jennifer Meddings1,2,3,
  3. Nathan Houchens1,2
  1. 1 Medicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
  2. 2 Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
  3. 3 Departments of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, Michigan, USA
  1. Correspondence to Dr Ashwin Gupta, Internal Medicine, VA Ann Arbor Healthcare System, Ann Arbor, MI 48105, USA; ashwing{at}

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Healthcare quality and safety span multiple topics across the spectrum of academic and clinical disciplines. Keeping abreast of the rapidly growing body of work can be challenging. In this series, we provide succinct summaries of selected relevant studies published in the last several months. Some articles will focus on a particular theme, while others will highlight unique publications from high-impact medical journals.

Key points

  • A single dose of intravenous amoxicillin and clavulanic acid nearly halves the risk of of maternal infection in women after operative vaginal delivery. The Lancet. 15 June 2019

  • Hospital-acquired complications are common during hospitalisations for low-value procedures, and when present, result in prolonged length of stay. JAMA Int Med. 25 February 2019

  • A model utilising computerised order entry events for postoperative complication surveillance has a high negative predictive value and may allow for more targeted manual chart review. JAMA Surg. 1 April 2019.

Prophylactic antibiotics in the prevention of infection after operative vaginal delivery (ANODE): a multicentre randomised controlled trial

The Lancet. 15 June 2019

Use of operative vaginal delivery, or delivery with the assistance of forceps or vacuum, is either already limited or declining worldwide,1 2 while concurrent rates of caesarean section are increasing.3 This trend may be due, in part, to maternal–fetal risks associated with operative vaginal delivery, including risk of infection.4 Pregnancy-related infections were responsible for nearly 20 000 maternal deaths globally in 20165 and multitudes more suffer from non-fatal infections.6 Evidence suggests that using prophylactic antibiotics for women giving birth by caesarean section can significantly reduce rates of wound infection, endometritis and serious maternal infection,7 which has led to a World Health Organisation (WHO) recommendation of prophylactic antibiotics for all women undergoing caesarean section delivery.8 Caesarean sections, however, are not without significant risk, including haemorrhage, infection, prolonged healing, increased cost and high likelihood of future caesarean delivery.9 Use of operative vaginal …

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.