Perioperafive antibiotic prophylaxis for cesarean section

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Author:
ZHANG Shu-min(Department of Obstetrics and Gynecology,Affiliated Drum Tower Hospital of Nanjing University Medical School,Nanjing 210008,China)
HU Ya-li(Department of Obstetrics and Gynecology,Affiliated Drum Tower Hospital of Nanjing University Medical School,Nanjing 210008,China)
LINGJing-xian(Department of Obstetrics and Gynecology,Affiliated Drum Tower Hospital of Nanjing University Medical School,Nanjing 210008,China)
DAI Yi-min(Department of Obstetrics and Gynecology,Affiliated Drum Tower Hospital of Nanjing University Medical School,Nanjing 210008,China)
WANG Zhi-qun(Department of Obstetrics and Gynecology,Affiliated Drum Tower Hospital of Nanjing University Medical School,Nanjing 210008,China)
Journal Title:
CHINESE JOURNAL OF PERINATAL MEDICINE
Issue:
Volume 13, Issue 02, 2010
DOI:
10.3760/cma.j.issn.1007-9408.2010.02.001
Key Word:
Cesarean section;Intraoperative period;Antibiotic;Prophylaxis

Abstract: Objectlve To investigate the effect of prophylactic antibiotics in peri-cesarean section(CS) for pregnant women with low risk of infection and the best regimen of prophylactic antibiotics. Methods A prospective randomized controlled trial was conducted on 720 pregnant women with low risk of infection,who underwent lower segment CS at the Affiliated Drum Tower Hospital of Nanjing University Meditsl School from November 2007 to October 2008.All subiects were randomized into four groups and different regimens of prophylactic antibiotics were given. Intravenous ceftizoxime sodium or clindamycin were selected.Group A included 176 gravidas without any antibiotics in peri-CS period;Group B were 190 gravidas who received a single dose of antibiotics within 30 min before CS;Group C consisted of 180 women receiving a single dose of antibiotics within 30 min before CS and another two doses after CS once daily;Group D were 174 women received antibiotics only after CS for five consecutive days once daily.The duration of temperature recovery to norrnal after the operation,postoperative morbidity,postoperative infection rate and postoperative hospital stay in the four groups were recorded and compared.Variance analysis,Chi-square test and Fisher's exact test were performed. Results The overall postoperative infection rate and postoperative morbidity were 0.83%(6/720)and 4.58 0A(33/720).respectively,and no significant difference was found in the postoperative infection rate among the 4 groups(P>0.05).The duration of temperature recovery to normal and postoperative hospital stay were shorter in group B[(41.9± 31.6)h and(4.8±1.1)d3 than in group A[(67.0±40.6)h and(5.7±1.O)d3 and group D [(70.1±39.9)h,(5.9±1.1)d,all P<0.01],and similar results were obtained when comparing those in group C[(41.1±36.5)h and(4.7±O.9)d] with group A and D.The postoperative morbidity in group B[1.05%(2/190)]was also significantly lower than that in group A [7.39%(13/176)]and D [9.20%(16/174)](all P<0.01),and it was the same when comparing this number of group C [1.11%(2/180)]with that of group A and D.However,significant difference was detected neither between group B and C,nor between group A and D in any of the 4 indicators. Conclusions Single dose of antibiotics intravenously within 30 rain before CS can significantly reduce the incidence of postoperative morbidity in pregnant women with low risk of infection.Repeated dose of antibiotics is unnecessary for the purpose of infection prevention for CS in patients with low risk of infection.

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