Cesarean Section and Prophylactic Antibiotics

Abstract

Infectious morbidity remains a leading cause of postoperative complications following caesarean delivery. The major infectious complications of caesarean delivery are fever, wound infection, endometritis and urinary tract infection. Postoperative surgical site infection remains a major source of illness and a less frequent cause of death in the surgical patient. The administration of prophylactic antibiotics with in specific interval has been shown to reduce the burden of surgical site infection, but adherence to proper timing guidelines remains problematic. Judicious use of antibiotics in the hospital through effective antibiotic policy and guideline development is then essential. Pathogenesis of post-cesarean infection: Postoperative endometritis is a polymicrobial infection caused by bacteria normally present in the hosts lower genital tract. The major microorganisms responsible for endometritis are aerobic gram-negative bacilli, principally E.coli; anaerobic gram-negative bacilli, principally Bacteroides species and gardnerella vaginalis; aerobic gram-positive cocci, primarily Group B and Group D streptococci; and anaerobic gram- positive cocci, specifically peptococcus species and peptostreptococcus species. 5