An Investigation into Perioperative Antibiotic Use during Lower Segment Caesarean Sections (LSCS) in Four Hospitals...

This investigation aims to assess the current practice of antibiotic prophylaxis and its use in various types of surgery in Oman.

A retrospective sample of 510 patients from four major hospitals were studied for the use of antibiotics in lower segment caesarean section (LSCS) surgeries.

There was a great diversity in the regimes from each hospital and only one had written guidelines. Although cephalosporin was used in the majority of cases, there was little consistency in the generation prescribed with second generation cefuroxime being the most popular (47% of all cases). The majority of cases also had metronidazole added. In one hospital, ampicillin was the prophylactic of choice and was routinely combined with oral amoxicillin. There were very few cases where only a single dose was given with most receiving at least 3 doses. In one extreme case, most patients received five days of prophylaxis with a 3rd gen-eration cephalosporin.

It appears that protocols for antibiotic prophylaxis have developed in an ad hoc fashion over time. It was found that none of the studied hospitals followed the Ministry of Health antibiotic guidelines, nor were they using any international standard or recommendation. Based on the available infection rates, a consistent policy with written guidelines appears to lead to the best outcomes for patients.