The efficacy of preoperative vaginal wash and single-dose antibiotic prophylaxis on the postoperative infectious morbidity

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.

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

Kathmandu University Medical Journal ◽

10.3126/kumj.v8i2.3554 ◽

1970 ◽

Vol 8 (2) ◽

pp. 179-184 ◽

Cited By ~ 8

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

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