Single-dose amoxycillin-clavulanic acid vs. ampicillin prophylaxis in emergency cesarean section

Abstract

Objective: To study the safety and efficacy of single-dose prophylaxis intravenous amoxycillin-clavulanic acid vs. ampicillin given after clamping of the cord in the emergency cesarean section. Methods: We conducted a randomized prospective double-blind study of 340 pregnant women undergoing emergency cesarean section. Each group received unlabeled but number coded 1.2 g of amoxycillin-clavulanic acid or 2 g of ampicillin single-dose intravenously. The patients' characteristics, operation variables and febrile morbidity of each group were compared. Results: There was no significant difference between the groups in mean age, parity, duration of labor, duration of ruptured membranes, number of vaginal examinations and indications for cesarean section. The incidence of febrile morbidity in the amoxycillin-clavulanic acid and ampicillin groups were 5.88 and 11.88%, respectively. The difference was not statistically significant. The febrile morbidity in patients who had more than six vaginal examinations was no different from patients who had less than six vaginal examinations in both groups. Conclusion: The febrile morbidity after emergency cesarean section in the amoxycillin-clavulanic acid group was no different from the ampicillin group in this study. Cost-effectiveness of both drugs should be further studied.