Timing of prophylactic antibiotic administration in the uninfected laboring gravida: A randomized clinical trial

Abstract

To the Editors: We read with interest the article by Thigpen et al1 regarding the timing of prophylactic antibiotics in women undergoing cesarean section. We commend the authors for undertaking this randomized clinical trial in an attempt to determine the optimal strategy to prevent postoperative infectious morbidity. However, we disagree with the author's conclusions that there are no differences in maternal infectious morbidity based on timing of antibiotic administration. Women receiving antibiotic prophylaxis before skin incision had a 7.8% rate of endometritis compared with a 14.7% rate of endometritis among women receiving antibiotics after umbilical cord clamping.