Prophylactic Antibiotics use in Cesarean Section

Abstract

This prospective study was done at obstetric unit, CMH Multan to identify best antibiotic prophylaxis for cesarean section as regards the dose, duration and route of administration postoperatively. A Prospective study was done over 06 months where all cesarean sections Performed from 1’ July till 31 December 2000 were included in the study. The main prophylactic antibiotic used was βlactamase resistant penicillin (500mg 6 hourly) given intravenously initially followed by oral therapy. Three doses of an aminoglycoside were added to cover gram negative infection for the first day only. The main outcome measures kept were febrile morbidity, wound sepsis and genital tract infection. The total number of CS during this period was 240. Among these 84 were emergency cesarean sections and 156 were elective CS. The overall incidence of postoperative infectious morbidity after strictly following the prophylaxis protocol was found 10.6%. Febrile morbidity was 17.5 %, wound Sepsis was recorded as 12 % and genital tract infection was found 2.5 %. Choosing the narrowest possible spectrum of antibiotics along with adherence to standard surgical practice can keep post-cesarean morbidity in acceptable range. This would not only restrict the treatment cost but also check the emergence of resistant strains.