scholarly journals Comparison of single versus multiple doses of antibiotic prophylaxis in reducing post-elective Caesarean section infectious morbidity

1970 ◽  
Vol 8 (2) ◽  
pp. 179-184 ◽  
Author(s):  
A Shakya ◽  
J Sharma
Keyword(s):  
Urinary Tract Infection ◽  
Single Dose ◽  
Caesarean Section ◽  
Antibiotic Prophylaxis ◽  
Multiple Dose ◽  
Elective Caesarean Section ◽  
Infectious Morbidity ◽  
Prophylactic Dose ◽  
Cord Clamping ◽  
Febrile Morbidity

Background: Puerperal sepsis is frequently in Caesarean section. Antibiotic prophylaxis may have significant impact in reduction of infections and thus the need to study its role in sepsis prevention systematically. Objective: The aim of this study is to compare the efficacy of single dose versus multiple doses of a first generation cephalosporin (with Metronidazole), to reduce postoperative infectious morbidity in elective caesarean section. Materials and methods: It was prospective clinical trial of hundred women undergoing elective caesarean section who received either a single prophylactic dose of Cefazolin with Metronidazole post-cord clamping, or multiple postoperative doses of antibiotics based on the standard protocol of the hospital. Duration of the study was seven months and twentytwo days (11th November 2004 to 30th June 2005).Women were compared on the basis of development of postoperative febrile morbidity, endometritis, urinary tract infection, wound infection and other infections. Results: There were no significant differences among the patients in single and multiple dose groups in terms of their age distribution, gravida, period of gestation, smoking status, body mass index, indications for elective caesarean section or operation characteristics. There were 4% and 6% febrile morbidity, 2 (4%) and 0 (0%) urinary tract infection, in the single dose and multiple dose groups respectively. But none of the differences were statistically significant. Conclusion: A single prophylactic dose of Cefazolin plus Metronidazole given post-umbilical cord clamping gives as much protection as multiple postoperative doses of Cefazolin/Cefalexin plus Metronidazole in preventing postoperative infectious morbidity in elective caesarean section. Key words: Antibiotic prophylaxis; Caesarean section DOI: 10.3126/kumj.v8i2.3554 Kathmandu University Medical Journal (2010), Vol. 8, No. 2, Issue 30, 179-184

scholarly journals Single dose ceftriaxone and metronidazole versus multiple doses for antibiotic prophylaxis at elective caesarean section in Mulago hospital: A randomized clinical trial

2018 ◽  
Vol 1 ◽  
pp. 11 ◽  
Author(s):  
Gideon Alex Mugisa ◽  
Paul Kiondo ◽  
Imelda Namagembe
Keyword(s):  
Single Dose ◽  
Caesarean Section ◽  
Multiple Dose ◽  
Dose Group ◽  
Controlled Trial ◽  
Elective Caesarean Section ◽  
Mulago Hospital ◽  
Multiple Doses ◽  
Febrile Morbidity ◽  
Operative Wound

Objective: To compare the incidence of post-operative infections among mothers who received single dose pre-operative ceftriaxone and metronidazole compared to multiple doses after delivery by elective caesarean section. Methods: This was (parallel, balanced randomization, 1:1) open label randomized controlled trial conducted Mulago Hospital, Department of Obstetrics and Gynaecology. Participants included in this study were pregnant women who had been admitted for elective caesarean section. The mothers were randomized to receive single dose of ceftriaxone and metronidazole minutes before the operation or multiple doses 30-60 during the operation and postoperatively. The primary outcome was post-operative wound infection. Secondary outcomes were clinical endometritis and febrile morbidity. The 174 eligible participants were randomized into one of the two treatment arms in a ratio of 1:1. The research assistants who collected the outcomes were blinded to the study allocation. Results: Of the 174 eligible participants who recruited; 87 were randomized to the single dose group while 87 to the multiple doses group. The participants were recruited from 17th September 2015 up to 29th February 2016. All the participants were followed up for two weeks after delivery.  Outcome data was available for 79 women in the single dose group and 81 women in the multiple dose group. There were no differences in the incidence of post-operative wound infections between the single dose arm versus the multiple dose arm (RR 1.895; 95% CI (0.2-21.4). There was no clinical endometritis and febrile morbidity observed during the 14 days of follow up. Conclusion: Single dose pre-operative antibiotic prophylactic with ceftriaxone and metronidazole is as effective as multiple doses in prevention of post-operative infectious morbidity in women who undergo elective caesarean section. We recommend the use of single dose ceftriaxone and metronidazole in women undergoing elective caesarean section in our setting. Trial registration: NCT02736682. Registration date, 7th April, 2016.

scholarly journals Ceftriaxone versus ampicillin/cloxacillin as antibiotic prophylaxis in elective caesarean section

2004 ◽  
Vol 10 (3) ◽  
pp. 277-282
Author(s):  
E. T. S. Ahmed ◽  
O. A. Mirghani ◽  
A. S. Gerais ◽  
I. Adam
Keyword(s):  
Clinical Trial ◽  
Single Dose ◽  
Caesarean Section ◽  
Antibiotic Prophylaxis ◽  
Apgar Score ◽  
Statistical Difference ◽  
Elective Caesarean Section ◽  
Controlled Clinical Trial ◽  
Induction Of Anaesthesia ◽  
Febrile Morbidity

Wecarried out a prospective, r and omized, controlled clinical trial to evaluate the clinical efficacy of ceftriaxone and ampicillin/cloxacillin prophylaxis in decreasing the frequency of post-caesarean section infection-related morbidity. Two hundred patients randomly received either ceftriaxone [single dose] or ampicillin/cloxacillin [3 doses] intravenously at induction of anaesthesia. There was no statistical difference in incidence of endometritis [P = 0.34], wound infection [P = 0.44], or other febrile morbidity [P = 0.5]. Eleven babies had a low Apgar score [< 8] in the ceftriaxone group and 13 in the ampicillin/cloxacillin group [P = 0.82]. There were 2 perinatal deaths in each group. One dose of ceftriaxone was as effective as ampicillin/ cloxacillin in preventing post-caesarean section complications and is easier to administer

scholarly journals Single vs Multiple Antibiotic Drug Regimen in Preventing Infectious Morbidity in Caesarean Section: A Randomised Clinical Trial

2021 ◽  
Author(s):  
Subhashchandra R Mudanur ◽  
Shreedevi S Kori ◽  
Aruna Biradar ◽  
Rajasri G Yaliwal ◽  
Dayanand S Biradar ◽  
...  
Keyword(s):  
Single Dose ◽  
Caesarean Section ◽  
Multiple Dose ◽  
Caesarean Delivery ◽  
Surgical Site Infections ◽  
Cost Effective ◽  
P Value ◽  
Infectious Morbidity ◽  
Group A ◽  
Group B

Introduction: Surgical site infections are a serious cause of maternal morbidity and mortality. Various preventive measures are being used to reduce the incidence of surgical site infections. One of them is the use of prophylactic antibiotics. In this study, authors have evaluated three antibiotic regimen with respect to preventing infectious morbidity in caesarean section. Aim: To study the efficacy and cost-effectiveness of a single dose (ceftriaxone) versus multiple doses of antibiotic therapy (ceftriaxone and ornidazole) administered preoperatively in women undergoing caesarean delivery. Materials and Methods: A prospective interventional study was conducted on 300 pregnant women undergoing emergency or elective caesarean delivery. Study was conducted at BLDE (DU) Shri BM Patil Medical College and Research Centre, Vijayapur, Karnataka, India. Patients were randomly assigned to three groups by block random sampling with 100 women in each group. Group A received Inj. ceftriaxone 1 gm single dose 60 minutes prior to commencement of surgery. Group B received Inj. ceftriaxone 1 gm along with Inj. ornidazole 500 mg intravenous infusion 60 minutes prior to commencement of surgery and Group C received Inj. ceftriaxone 1 gm and Inj. ornidazole 500 mg intravenous infusion 60 minutes prior to commencement of surgery and a repeat dose 12th hourly for 24 hours followed by Tab. cefixime 200 mg and Tab. ornidazole 500 mg twice daily for four days postoperatively. The effectiveness of therapy was measured in terms of adverse effects of antibiotics such as nausea and vomiting and postoperative complications like pyrexia, foul smelling lochia, surgical site infections, uterine tenderness, peritonitis and endometritis. Results: There was no statistical difference in outcome measures in side-effects of antibiotics (p-value=0.13), fever (p-value=0.68), lochia discharge (p-value=0.88), wound infection (p-value=0.39) and peritonitis (p-value=0.30) among the three groups. The single dose medication in group A had a cost of Rs.60 INR (0.82 cents USD), which was significantly less compared to the multiple dose regimens in group B that cost Rs.203 INR ($2.76 USD). The mean hospital stay in non infectious and infectious patients were 5 and 10 days in present study (p<0.0001). Conclusion: Caesarean delivery poses 5-20 times greater risk of postoperative infection when compared to vaginal birth. There has been a shifting trend of increasing caesarean deliveries and postoperative infections can contribute to overwhelming health and economic burden. Present study shows outcome measures which were statistically insignificant among the three study groups with different prophylactic regimen for caesarean delivery, so it’s safe to state that both single dose and multiple dose regimen provided equal protective coverage in reducing maternal infectious morbidity. Also, single dose regimen proved to be cost-effective. So, to conclude single dose prophylactic antibiotic given preoperatively in caesarean section is both cost-effective and as is efficient.

A Comparative Study of Single Dose and Multiple Dose Antibiotic Prophylaxis In Caesarean Section

2021 ◽  
Vol 8 (3) ◽  
pp. 89-93
Author(s):  
Dr. Poorvi Agarwal ◽  
Dr. Harshal Nimbannavar ◽  
Dr. Prajakta Khose ◽  
Dr. Supraja Subramanian ◽  
Dr. Himadri Bal
Keyword(s):  
Single Dose ◽  
Caesarean Section ◽  
Antibiotic Prophylaxis ◽  
Multiple Dose ◽  
Prophylactic Antibiotic ◽  
Dose Schedule ◽  
Antibiotic Use ◽  
Skin Incision ◽  
Significant Difference ◽  
Group B

Background: Rampant antibiotic use brought about its own set of problems like the rise in incidence of antibiotic resistant strains, allergies and other complications of antibiotic use. Unfortunately in many of our set ups we are still stuck in prolonged post-operative antibiotic regimes. This study aims to fill that lacunae and thereby aid our gradual shift away from over reliance on prolonged antibiotic usage in prevention of SSI. Hence we decided to investigate the efficacy of the use of a single prophylactic intravenous dose of antibiotic vis a vis multiple doses in reducing post-operative infective morbidity in caesarean sections. Methods: The study included 200 patients at term, satisfying the inclusion and exclusion criteria, reporting to the labour room and undergoing caesarean section. The patients were then divided into two groups of 100 each by simple randomization. Patients in Group A were given a single dose of Inj. Cefotaxime 1gm IV + Inj. Metronidazole 500 mg IV infusion 30 minutes before the skin incision. Group B cases were given the first dose of Inj. cefotaxime 1g IV + Inj. metronidazole 500 mg IV 30 minutes before the skin incision followed by injectables for 2 days: Inj. cefotaxime 1g IV BD and Inj. metronidazole 500mg IV TDS. Subsequently for the next 3 days Tablet Cefixime 200mg BD and Tablet Metronidazole 400mg TDS were administered orally. Results:  The present study did not show any significant difference in the post operative infection incidence between the single dose and multiple dose schedule. Conclusion: our study makes an important observation regarding use of antibiotic prophylaxis and its duration for prevention of post operative infections in mothers without compromising any safety aspects of either the mother or the child.  As noted in our study, there was no difference in the outcome as regards post operative infectious morbidity in patients of both the groups. Hence, based on the findings of our study we conclude that single dose prophylactic antibiotic should be the norm for caesarean sections.

scholarly journals Effectiveness of oral versus parenteral antibiotics in cesarean section: an observational study

2020 ◽  
Vol 10 (1) ◽  
pp. 186
Author(s):  
Malini Bharadwaj ◽  
Rani R. Momaya ◽  
Rituja Kaushal
Keyword(s):  
Single Dose ◽  
Caesarean Section ◽  
Observational Study ◽  
Antibiotic Prophylaxis ◽  
T Test ◽  
P Value ◽  
Common Indication ◽  
Infectious Morbidity ◽  
Treatment Implementation ◽  
Significant Difference

Background: Women undergoing caesarean section are associated with high rates of post-operative infections, which causes significant rise in infectious morbidity, duration of hospital stay and cost treatment. Implementation of appropriate antibiotic prophylaxis is desirable to prevent these complications. We aimed to observe the outcome of Intravenous single dose antibiotic prophylaxis pre-operatively followed by oral antibiotics post-operatively, in comparison to other group with multiple dose Intravenous antibiotic prophylaxis post-operatively.Methods: An observational study conducted in the department of obstetrics and gynaecology, L.N.M.C and J.K. Hospital, Kolar Road, Bhopal, on patients undergoing Elective or Emergency Lower segment caesarean section (LSCS) for a period of 6 months, on 100 subjects, with 50 participants in each group. Null hypothesis was invalidated by statistically analysing the data using chi square test, Unpaired t-test and odds ratio.Results: Prevalence of c-section was more in 25-31year age group. Abnormal presentation was the most common indication for elective LSCS in both the groups (8%), non-progress of labour and foetal distress was the most common indication for emergency LSCS in group A and B respectively (10%). There was statistically insignificant difference in the occurrence of post-operative complications in both the groups (chi sq. value=0.4285, p value=0.5127) with overall, most common complication was febrile morbidity (8% vs.12%). Significant difference noted in total bed occupancy days (unpaired t-test 1.9844) (p-value.0.000000049<0.05%).Conclusions: We recommend the use of cost-effective single dose antibiotic prophylaxis in prevention of post-operative infectious morbidity in women undergoing caesarean section.

scholarly journals ELECTIVE CAESAREAN SECTION

2010 ◽  
Vol 17 (02) ◽  
pp. 304-307
Author(s):  
ROBINA KAUSAR ◽  
LUBNA YASMEEN
Keyword(s):  
Caesarean Section ◽  
Tract Infection ◽  
Antibiotic Prophylaxis ◽  
Elective Caesarean Section ◽  
Cost Effective ◽  
Discharge Data ◽  
Infectious Morbidity ◽  
Group I ◽  
Antibiotic Regime ◽  
Group Ii

Objective: To compare short antibiotic prophylaxis versus prolonged antibiotic regime in terms of morbidity control of infection in patients undergoing elective caesarean section. Study Design and Settings: It was a experimental study done in Gynae/Obs unit I Holy Family Hospital Rawalpindi over a period of one year. Patients and Methods: Total of 200 patients selected randomly were admitted in antenatal ward for elective caesarean section. All these booked patients with age less then 40 years, gestational age of > 38 weeks, Hb >10g/dl, with no signs of genitourinary or respiratory tract infection were included in the study. These patients were divided in two groups with 100 patients in each group. In group I, short antibiotic prophylaxis in form of three doses of injectable antibiotic was given. In group II prolonged antibiotic regime wasgiven as 5 days course. Augmentin was chosen as it has proven efficacy and good coverage for microorganisms of urogential tract and skin. Injection Augmentin was given in dose of 1.2g (1g Amoxycillin + 200mg clavulanic acid) I/V x BD. All operation were performed by transverse lower segment caesarean section by registrars and consultants. Anaesthesia used was mostly spinal and more than 80% of the patients were having body mass index of <30. These patients were followed in postnatal ward for post operative infectious morbidity till discharge. Data collected through proformas was entered in computer and analyzed using SPSS. Result: Over all post operative infectious morbidity in group I was 29% and in group II 30% (p = 0.877). Post operative fever in group I was 09% and group II 08% (p = 0.800), while frequency of endometritiswas found to be same in both groups which was 03%. No case of chest infection was recorded in both groups. Only 5% patients in group I and 4% patients in group II were reported to have urinary tract infection (p = 0.733). The most common complication found during study was wound infection, the rate being 12% in group I and 15% in group II (p = 0.535). So the overall results showed no statistically significant differencebetween two groups. Conclusion: Short antibiotic prophylaxis is as effective as prolonged antibiotic regimen. As it is cost effective and most of our patients come from low socio economic class, so this short antibiotic prophylaxis should be recommended routinely for all elective caesarean sections.

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