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Single-dose ampicillin for cesarean section prophylaxis.

S L Padilla, M R Spence, P J Beauchamp

    Obstetrics and Gynecology
    |April 1, 1983
    PubMed
    Summary
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    Administering ampicillin intravenously to cesarean section patients significantly reduced postoperative infection rates. This antibiotic prophylaxis proved effective, especially in primary cesarean sections, preventing serious infections.

    Area of Science:

    • Obstetrics and Gynecology
    • Infectious Disease Prevention
    • Pharmacology

    Background:

    • Cesarean section is a common surgical procedure with a risk of postoperative infections.
    • Antibiotic prophylaxis is standard practice, but optimal agents and timing require ongoing evaluation.
    • Postpartum infections contribute significantly to maternal morbidity.

    Purpose of the Study:

    • To evaluate the efficacy of a single intravenous dose of ampicillin in preventing postoperative infections following cesarean section.
    • To compare infection rates between ampicillin and placebo groups in a randomized, double-blind trial.
    • To assess the impact of ampicillin timing (preoperative vs. intraoperative) on infection incidence.

    Main Methods:

    • A randomized, prospective, double-blind study involving 71 patients undergoing cesarean section.

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  • Intravenous administration of either 2g ampicillin or an identical placebo.
  • Infection surveillance included assessment of overall postoperative morbidity and specific serious/wound infections.

    • Main Results:

    • Ampicillin significantly reduced overall postoperative infection rates from 59.4% in the placebo group to 14.7% (P < .0001).
    • In primary cesarean sections, ampicillin decreased infection incidence to 6.3% compared to 65% with placebo (P < .0004).
    • For repeat cesarean sections, ampicillin showed a trend towards lower infection rates (22% vs. 53%), though not statistically significant (P > .05).

    Conclusions:

    • A single intravenous dose of ampicillin is highly effective in reducing postoperative infection rates after cesarean section.
    • Ampicillin prophylaxis is particularly beneficial in primary cesarean deliveries.
    • No serious infections or wound infections were observed in patients who received ampicillin, suggesting its protective role.