Antibiotic prophylaxis in cesarean section

Abstract

We propose a nation-wide prospective investigation on the rate of infections associated with cesarean section to set up rational guidelines for antibiotic prophylaxis.

Is routine cervical dilatation necessary during elective caesarean section? A randomised controlled trial

“…In our study, there was no significant difference in the post‐caesarean febrile morbidity, endometritis and wound infection. Administration of prophylactic antibiotics in our study was mostly confined to patients with a high risk for postoperative infections, as in many previous study 19,20 …”

Single dose versus multiple dose of antibiotic prophylaxis in caesarean section: a systematic review and meta‐analysis

“…The rationale for this recommendation is that this agent is considered cost‐effective when compared with broad‐spectrum antibiotics or multiple dose regimens . However, there is considerable inconsistency in the implementation of this recommendation . This is driven by concerns regarding the drug of choice, optimal regimen, adverse effects, bacterial resistance and economic resources .…”

“…Despite the evidence showing single dose to be as effective as multiple dose regimens, recent trials suggest multiple doses of an extended spectrum regimen may reduce infectious morbidity . Furthermore, recent surveys report an inconsistent and variable application of antibiotic prophylaxis in caesarean section, worldwide . This is probably due to available financial resources, current knowledge of antibiotic resistance and concerns regarding adverse effects on mother and fetus.…”

Current debate on the use of antibiotic prophylaxis for caesarean section

“…99,100 Although antibiotic prophylaxis for elective CD has been shown to be cost effective, 35,101 there has been reluctance to implement the recommendations, 102,103 as well as inconsistency in their implementation. 104,105 Several questions have been raised including the optimal indication, drug of choice and drug regimen, [106][107][108][109] and whether prophylaxis should be given to all women or only those considered to be at high risk. 35,[110][111][112] Current debate on the use of antibiotic prophylaxis for CD Currently, the Cochrane Database of Systematic Reviews, the American College of Obstetricians and Gynecologists and the Centers for Disease Control 16,91,113 recommend narrow-range first-generation cephalosporins, like cefazolin, to be administered after umbilical cord-clamping for prophylaxis against infection after CD.…”