Abstract
Review of recommendations on prophylactic antibiotic use in cesarean section-A Review Article
Highlights
Women who deliver by Cesarean Section [CS] are 5-20 times more predisposed to postpartum infections including endometritis, urinary tract infections, surgical site infections than women who deliver vaginally[1,2]
In Cochrane review (2014) of 95 studies enrolling more than 15,000 women, the use of prophylactic antibiotics in woman who underwent CS reduced the incidence of wound infection (RR 0.40, 95% CI 0.35 to 0.46, studies, 14,407 women), endometritis (RR 0.38, 95% CI 0.34 to 0.42, studies, 13,548 women) and maternal serious infectious complications (RR 0.31, 95% CI 0.20 to 0.49, 32 studies, 6159 women) when compared with no treatment
In a prospective comparative study by OLeary et al in 1986, post cesarean morbidity was lesser in ampicillin-gentamycin group as compared to ampicillin alone[8,9]
Summary
Women who deliver by Cesarean Section [CS] are 5-20 times more predisposed to postpartum infections including endometritis, urinary tract infections, surgical site infections than women who deliver vaginally[1,2]. The post cesarean infectious morbidity was reduced in both in high risk and low risk patients[3]. The rates of surgical site infection especially in the presence of other risk factors like anemia, CS in labor, woman on immunosuppressive therapy may be decreased with effective antibiotic usage. Till date there is no evidence based global guidelines regarding choice of antibiotic, epidemiological data including bacteriology and sensitivity patterns of these infections, especially in resource limited countries so as to identify an ideal drug. A cost effective prophylactic antibiotic regimen with safe maternal and neonatal outcomes should be sought.
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