Incidence of postpartum endomyometritis following single-dose antibiotic prophylaxis with either ampicillin/sulbactam, cefazolin, or cefotetan in high-risk cesarean section patients
✍ Scribed by N. Noyes; A.S. Berkeley; K. Freedman; W. Ledger
- Publisher
- Hindawi Publishing Corporation
- Year
- 1998
- Tongue
- English
- Weight
- 171 KB
- Volume
- 6
- Category
- Article
- ISSN
- 1064-7449
No coin nor oath required. For personal study only.
✦ Synopsis
Objective: To assess the efficacy of single-dose antibiotic prophylaxis against postpartum endomyometritis in high-risk cesarean section patients.
Design: Patients were administered one of three single-dose antibiotic regimens following umbilical cord clamping after cesarean section delivery.
Setting: Prospective randomized trial at a university-based hospital.
Patients: The study evaluated 293 consenting women undergoing cesarean section who had either experienced labor for a duration of Ն 6 hr or rupture of amniotic membranes.
Main outcome measures: Development of postpartum endomyometritis.
Results: The incidence of postpartum endomyometritis was 7/95 (7.4%) following the ampicillin/ sulbactam regimen, 14/98 (14.3%) after the cefazolin regimen, and 11/99 (11.1%) after the cefotetan regimen. There was no significant difference in postpartum infection among the three study arms. In addition, the incidence of endomyometritis in the three single-dose study arms was not higher than previously noted in studies where three doses of antibiotic were administered.
Conclusion: Single-dose antibiotic prophylaxis should replace the standard triple-dose therapy for uninfected women undergoing cesarean section who are at risk for postoperative endomyometritis. Ampicillin/sulbactam, cefazolin, and cefotetan are all reasonable antibiotic choices for single-dose therapy.