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Systemic antibiotic prophylaxis in elective cesarean delivery

D E Rizk1, H Nsanze, M H Mabrouk

  • 1Department of Obstetrics and Gynecology, United Arab Emirates University, Al-Ain.

International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics
|August 4, 1998
PubMed
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Prophylactic antibiotics at elective cesarean delivery did not reduce postoperative morbidity. This study found no significant difference in febrile morbidity or infection rates between women who received antibiotics and those who did not.

Area of Science:

  • Obstetrics and Gynecology
  • Infectious Disease Prevention
  • Surgical Site Infections

Background:

  • Elective cesarean delivery is a common surgical procedure.
  • Postoperative morbidity, including infection, is a concern following cesarean delivery.
  • The use of prophylactic antibiotics aims to reduce infection risk.

Purpose of the Study:

  • To evaluate the effectiveness of prophylactic antibiotics in preventing postoperative morbidity in women undergoing elective cesarean delivery.
  • To determine if cefuroxime administration impacts infection rates or febrile morbidity.

Main Methods:

  • A randomized controlled trial involving 120 women undergoing elective cesarean delivery.
  • Participants were randomized to receive intravenous cefuroxime at cord clamping (n=59) or no antibiotic prophylaxis (control, n=61).

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  • Outcomes assessed included febrile morbidity, endometritis, wound infection, and hospital stay.

    • Main Results:

    • No statistically significant difference in febrile morbidity (P=0.09) or endometritis (P=0.09) between the antibiotic and control groups.
    • Similar rates of wound infection (P=0.09) and microbiological evidence of infection (P=0.08) were observed.
    • Hospital stay duration was comparable between groups (P=0.06).
    • Staphylococcus aureus was the most frequent pathogen identified.

    Conclusions:

    • Prophylactic antibiotic administration at elective cesarean delivery was not associated with a reduction in postoperative morbidity.
    • Current prophylactic antibiotic strategies may not be beneficial for all elective cesarean deliveries.
    • Further research may be needed to identify specific patient populations or antibiotic regimens that could improve outcomes.