Prevention of endomyometritis by local application of antibiotic solution during cesarean section

Previous studies have demonstrated a reduction in the incidence of endomyometritis by using irrigation with 1000 ml of saline as a diluent at cesarean section. In this study 2 gm of cefoxitin sodium in 20 ml of saline solution was used for local application to the uterus and abdominal wound in 100 patients undergoing emergency cesarean section; results were compared to those in 100 patients who received no antibiotic at operation. Six patients in the treatment group developed endomyometritis as opposed to 33 in the untreated group (p less than 0.001) and hospital stay was reduced by almost 2 days (p less than 0.001). Local use of cefoxitin sodium appears effective in reducing the incidence of endomyometritis. A prospective double-blind study, however, is imperative before definite conclusions can be made.