Single Dose Prophylactic Antibiotic in Caesarean Delivery and its Effect on Maternal Infectious Morbidity: A Prospective Observational Study

Abstract

Introduction: Caesarean delivery is the most common surgery performed in obstetrics. Antibiotics have revolutionised the surgical practise in this era. But multidrug resistance is a challenging issue in day to day practise. So, antibiotics have to be administered judiciously at the appropriate time with respect to surgery. Aim: To determine whether the administration of single dose injection ceftriaxone 1 gm intravenously prior to skin incision was superior to administration at the time of cord clamping for prevention of post-caesarean maternal infection. Materials and Methods: A prospective observational study was conducted in BLDE (DU) Shri BM Patil Medical College and Research Centre, Vijayapura, Karnataka, India. Patients undergoing caesarean sections for singleton term pregnancies both elective and emergency with intact membranes were included in study during one-year period. Alternatively, group A received 1 gm injection ceftriaxone intravenously 60 minutes before skin incision and group B received at the time of cord clamping during surgery. Chi-square (χ2 ) test was used for association between two categorical variables. Results: Incidence of obstetric complications such as nausea (0.5% vs 0.0%) and wound infections (6.6% vs 4.1%) were more in patients who received a single dose of ceftriaxone at cord clamping than patients receiving the same antibiotic, preoperatively whereas, incidence of postoperative fever was more in group A (4.1%) than group B (3.3%) which was although not significant but is an important finding in this study. Conclusion: Administration of single dose antibiotic either preoperatively or at the time of cord clamping was not statistically significant in reducing the incidence of wound infections.

Keywords

• endometritis
• postoperative fever
• surgical site infections