Short versus long course of prophylactic antibiotics

The use of prophylactic antibiotics to reduce post-cesarean section febrile morbidity has been advocated since 1968. Although this approach has theoretical and actual disadvantages, all but one study found a reduction in febrile morbidity when prophylactic antibiotics were used. An unresolved question was the duration of antibiotic therapy. A double-blind randomized study compared a long course of ampicillin (3 days) to a short course of ampicillin (three doses) to placebo. The long course of prophylactic antibiotics reduced febrile morbidity significantly better (p less than 0.025) than the short course, and hospital stay was also significantly reduced when compared to placebo (significance, p less than 0.01). A longer course (3 days) of antibiotics was superior to a short course (three doses) in situations in which prophylactic antibiotics were used.