Single vs Multiple Dose of Cefazolin Prophylaxis in Elective Cesarean Section

Abstract

Introduction: Caesarean section (CS) is one of port d’ entrée from
 infection in women and it is related to maternal morbidity during
 puerpureal period. Until now, there is still lack of consensus
 regarding prophylactic antibiotic protocol before CS procedure. This
 study aims to determine the comparative efficacy between single
 dose and multiple doses of cefazolin prior incision toward the
 incidence of maternal infection.
 
 Methods: This was a single-blind, randomized, clinical trial study
 with two methods of intervention including 2-gram single dose
 cefazolin at 30 minutes’ prior incision and 2-gram single dose
 cefazolin at 30 minutes’ prior incision continued 1-gram cefazolin
 after 8 hours of procedure. We recruited women undergone elective
 CS at Fatmawati and Anna Hospital, Jakarta from January to March
 2016. The primary outcomes were surgical site infection, urinary
 tract infection, and endometritis based on clinical findings during 30
 days of follow-up period.
 
 Results: A total of 46 subjects were recruited which 23 of them were
 in single dose cefazolin group and the other 23 subjects were in
 multiple dose of cefazolin group. There were 9 subjects having
 infection (19.6%). There was no statistical difference in the
 incidence of infection between two groups (p=1.00; relative risk
 0.80, 95% CI 0.25-2.61).
 
 Conclusion: Single dose of cefazolin shows similar rates of infection
 incidence to multiple dose. Therefore, single dose of cefazolin can be
 a protocol in CS based on its efficacy and efficiency.
 
 [Indones J Obstet Gynecol 2017; 5-1: 60-65]
 
 Keywords: cefazolin, maternal infection, multipe dose, single dose