Short term antibiotic prophylaxis for emergency cesarean delivery : Is there a difference? (original) (raw)
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Evaluation of the efficiency of antibiotic prophylaxis in cesarean cases
Proceedings in Obstetrics and Gynecology, 2016
Background: In recent years the rate of cesarean section has significantly increased.To determine the efficacy of prophylactic antibiotics in reducing infectious morbidity after cesarean section. Objectives: In our study, we aimed to evaluate the efficiency of prophylactic antibiotic administration by comparing three groups using single, multiple and no prophylactic antibiotic therapy. Materials and Methods: Our study is a prospective, randomized controlled study including emergent cases, that developed cesarean indication while in active labor, and elective cesarean cases. A total of 90 patients were included in the study, including 30 patients who underwent cesarean delivery and did not undergo an antibiotic prophylaxis (Group 1), 30 patients who underwent a single dose antibiotic prophylaxis (Group II) and 30 patients who underwent multiple dose antibiotic prophylaxis (Group III). Results: The incidence of wound infection was significantly higher in cases that were not using antibiotics at postoperative days 3, 5 and 7 compared to the cases using single and multiple antibiotics. There was not a significant difference between groups in terms of endometritis. Conclusion: Administration of prophylactic antibiotics prevent wound infection but does not prevent development of endometritis.
The Journal of Obstetrics and Gynecology of India, 2010
Objective: To compare amoxycillin-clavulanic acid with cefazolin as short term antibiotic prophylaxis in women undergoing hysterectomy and elective cesarean section. Method: Sixty women undergoing hysterectomy were randomly assigned either to 2.4g intravenous amoxycillin-clavulanic acid (AMX/CL) or 2g cefazolin 30 min before hysterectomy. One hundred and twenty two women delivered by elective cesarean were randomized to a single dose of either of the above antibiotics at cord clamping. Each patient was assessed daily until discharge for evidence of febrile status and the presence of infection at the operative site and urinary tract. Results: Infectious morbidity was found in 11% and 12.5% of hysterectomy patients in AMX/CL and cefazolin groups respectively. Ten women had post-cesarean infections (six AMXCL, four cefazolin, P=0.51) Conclusion: Broad spectrum amoxycillin-clavulanic acid was not superior to cefazolin in the prevention of postoperative infection when given as prophylaxis in hysterectomy and elective cesarean cases.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2016
Background: To compare amoxicillin-clavulanic acid with cefazolin as short term antibiotic prophylaxis in women undergoing hysterectomy and elective casarean section. Methods: 60 women undergoing hysterectomy were randomly assigned either to 2.4 g intravenous amoxicillinclavulanic acid (AMX/CL) or 2 g cefazolin 30 min before hysterectomy. 122 women delivered by elective cesarean were randomized to a single dose of either of above antibiotics at cord clamping. Each patient was assessed daily until discharge for evidence of febrile status and the presence of infection at the operative site and urinary tract. Results: Infectious morbidity was found in 11% and 12.5% of hysterectomy patients in AMX/CL and cefazolin cases respectively. 10 women had post-cesarean infections (6 AMX/CL, 4 cefazolin, p=0.51). Conclusions: Broad spectrum amoxicillin-clavulanic acid was not superior to cefazolin in prevention of postoperative infection when given as prophylaxis in hysterectomy and elective cesarean section.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2020
Background: Post-operative infections in obstetrics and gynecological settings have been higher compared to other specialties. Women undergoing caesarean section have 5 to 20-fold greater risk for infection compared with vaginal delivery. Many studies reported antimicrobial prophylaxis prevent post-operative infections. Hence this study concentrates the evaluation of the prescribing antimicrobial use and to assess the frequency of post-operative morbidity related to infection in subjects undergoing caesarean section. The aim of the study was to analysis the effectiveness, prophylactic antibiotics (amoxicillin versus ceftriaxone) and to evaluate the post-operative (caesarean) infections in patients undergoing lower segment caesarean section (elective and emergency).Methods: This is a prospective observational study which assessed the effectiveness and use of prophylactic antibiotics in patients undergoing cesarean section at department of obstetrics and gynecology. The study was cond...
2022
Objective To compare the effectiveness of single dose to multiple doses antibiotic prophylaxis for elective caesarean section in Korle-Bu Teaching Hospital.Design Randomized non-inferiority comparative studySetting and population Eighty-six (86) pregnant women admitted for elective caesarean section and treated with single dose antibiotic and 86 pregnant women admitted for elective caesarean section and treated with multiple doses antibiotic in Korle-Bu Teaching Hospital, Ghana.Methods This study was randomized into two groups. Group A were given single dose of Amoxicillin-clavulanate potassium and metronidazole while group B were given multiple doses. The patients were examined on postoperative day 3, 14, 42 for signs of wound infection and endometritis. Statistical analysis was done using the student t-test and the chi-square test. Results were presented in cumulative incidence and as odds ratio together with 95% confidence intervals and P-value. Main outcome Effectiveness of sing...
Comparison of Single Dose Prophylactic Antibiotics Versus Five Days Antibiotic in Cesarean Section
Journal of Evolution of Medical and Dental Sciences, 2014
To compare if single dose antibiotic is as effective as multiple doses in prevention of post-operative infection in caesarean section. To compare the cost effectiveness of drugs in both the groups. MATERIAL AND METHOD: This prospective randomized controlled study was carried out to evaluate the effectiveness of single dose antibiotic versus multiple doses in caesarean section. The study population consisted of 600 patients that were randomly allocated to single or multiple dose groups. All potentially infected cases were excluded from this study. All patients received inj Cefotaxime IV half hour before surgery. In addition the multiple dose group received antibiotics for five days post-operatively. Each patient in the study was observed till discharge for presence of any morbidity like endometritis, urinary tract infections, and wound infections. STATISTICAL ANALYSISIS: Fischer exact test, unpaired t test used for analysis. RESULTS: There was no statistically significance in the rate of infections in both the groups. The rate of febrile morbidity, endometritis, urinary tract infection and wound infections were statistically not significant. However the difference in cost of antibiotic in both the groups was significant. CONCLUSIONS: Single dose antibiotics are effective as multiple doses in prevention of post-operative infections in caesarean sections Careful periodic surveillance of antibiotic prophylaxis is necessary to detect the emergence of drug resistant strains of bacteria in our institution because it caters to the needs of local population.
Single Versus Multiple Dose Regimen of Prophylactic Antibiotic in Cesarean Section
Nepal Journal of Obstetrics and Gynaecology, 2014
Aims: The purpose of this study was to compare the efficacy of single combined dose of Cefotaxime and Metronidazole against conventional regimen of Ampicllin and Metronidazole for five days for the prevention of infectious morbidities in cesarean deliveries. Methods: This study was carried out at Paropakar Maternity and Women’s Hospital, Kathmandu from April to August 2011. Hundred patients, who had cesarean deliveries for various indications, were divided into two groups with fifty on each arm. Patients in group I were treated with intravenous single dose of Cefotaxime and Metronidazole after cord clamping, whereas those patients in group II were treated with Ampicillin and Metronidazole for five days. Efficacy of the treatment was compared in terms of postoperative infectious morbidities, duration of hospital stay and cost of antibiotics. Results: Overall ten cases (10%) had post-operative complications in which eight (8%) had infectious and two (2%) had thrombophlebitis. The infe...
West African Journal of Medicine, 2021
Background: The need for restrictive use of antibiotics has become a contemporary issue, hence the drive for reduction in the duration of perioperative antibiotic use without compromising care. Objective: The aim of this study was to compare the efficacy of short course versus long course antibiotic prophylaxis for caesarean section Methodology: This was a randomised controlled study in which I66 patients admitted for elective or emergency caesarean section at National Hospital Abuja were randomly allocated into two parallel treatment groups in 1:1 allocation ratio. The study group received intravenous dose of 1g of ceftriaxone with 500mg of metronidazole stat post umbilical cord clamping. While the control group received post-operative doses of intravenous ceftriaxone 1g 12 hourly with 500mg of metronidazole eight hourly for 24 hours, then oral cefuroxime 500mg twice daily and metronidazole 400mg thrice daily for five days. Outcome measures included febrile morbidity, wound infection and clinical endometritis. Data was analysed with SPSS version 23. Results: The socio-demographic and clinical characteristics were comparable in both groups. There were no statistical differences in the incidence of febrile morbidity (0% vs. 1.3%, P=1.000) and wound infection (12.2% vs. 12.8%, P=0.902, RR=0.902, 95% CI 0.409-2.203) in the study and control groups. There was no case of clinical endometritis in both groups. The difference in the cost of antibiotics was however statistically significant (t=26.847, P=0.001). Conclusion: Short course antibiotics has comparable efficacy to long course antibiotics in the prevention of post caesarean section infectious morbidity.
Sri Lanka Journal of Obstetrics and Gynaecology, 2018
To determine the effectiveness and safety of single doses antibiotic against conventional multiple doses regimen on clinically detectable maternal and neonatal infectious morbidity. Method This is a randomized, non-blind clinical trial on women undergoing caesarean section. By block random sampling, 369 women, who were enrolled in this study, 185 (50.1%) randomly received single dose of antibiotics and 184 (49.8%) received multiple postoperative doses of antibiotics. All potentially infected cases were excluded. These patients were followed up prospectively for infectious and neonatal complications till discharge and verbal enquiry or direct observation done during suture removal. The effectiveness was measured in terms of febrile morbidity, surgical site infection, endometritis, urinary tract infection, other infection along with duration of hospital stay. Chi-square analysis (Fisher's Exact
Perioperative Antibiotic Prophylaxis for Nonlaboring Cesarean Delivery
Obstetrics & Gynecology, 2009
Objective-To estimate the efficacy of antibiotic prophylaxis at time of non-laboring cesarean delivery in reducing postpartum infection-related complications. Methods-We performed a secondary analysis of an observational study of cesarean deliveries performed at 13 centers from 1999-2000. Patients were included if they had a cesarean delivery prior to labor, did not have an antepartum or intrapartum infection, and were not given antibiotics at delivery for reasons other than prophylaxis. The occurrence of postpartum endometritis, wound infection, and other less common infection-related complications was compared between those who did and did not receive antibiotic prophylaxis. Results were adjusted for smoking, payor status, gestational age and body mass index (BMI) at delivery, race, diabetes, antepartum infections, presence of anemia, operative time, type of cesarean delivery (primary or repeat), and center. Results-Of the 9,432 women who met study criteria, the 6,006 (64%) who received antibiotic prophylaxis were younger, heavier at delivery, and were more likely to be African American, receive public insurance, and have diabetes. Patients who received antibiotic prophylaxis were less likely to develop postpartum endometritis [121 (2.0%) vs 88 (2.6%); adjusted odds ratio [OR] 0.40; 95% confidence interval [CI] 0.28-0.59] or wound infection [31 (0.52%) vs 33 (0.96%); adjusted OR 0.49; 95% CI 0.28-0.86]. Conclusion-Antibiotic prophylaxis at the time of non-laboring cesarean delivery significantly reduces the risks of postpartum endometritis and wound infection.