Key result
Single-dose antibiotics show no difference in surgical site infections vs a 7-day regimen after caesarean section.
Why the study?
High antibiotic usage increases antibiotic resistance, side effects, and healthcare costs, yet prolonged antibiotic prophylaxis is common in the Indian setting for caesarean sections.
Does single dose antibiotic prophylaxis prevent post-operative infections as effectively as a prolonged 7-day antibiotic course in patients undergoing caesarean section?
RCT (n=100)
Open-label
No
Does single dose antibiotic prophylaxis prevent post-operative infections as effectively as a prolonged 7-day antibiotic course in patients undergoing caesarean section?
Single dose antibiotic prophylaxis is as effective as a prolonged 7-day course in preventing post-operative infections following caesarean section.
Answers are grounded in this paper and cite their sources.
Single-dose prophylaxis may suffice post-caesarean; leaves open confirmation by randomized trials before practice change.
Background: A very high usage of antibiotics have resulted in increase in incidence of antibiotic resistant micro-organisms, drug side effects and increased health care expenditure which is a bane in a resource limited setting and in poor or developing countries. These days, a long duration of antibiotic usage is characterized in Indian set up for prophylaxis during caesarean section. In the current study we evaluated single dose antibiotic use vs prolonged antibiotic use in subjects undergoing caesarean section. Aims and Objectives: To compare single dose antibiotic use vs. multidose antibiotic use in subjects undergoing caesarean section. Materials and Methods: The study included 100 patients at term, satisfying the inclusion and exclusion criteria, reporting to the labour room and undergoing caesarean section. The patients were divided into two groups of 50 subjects each. Patients in Group I was given a single dose of Inj. Cefotaxime 1gm IV and Inj. Metronidazole 500 mg IV infusion 30 minutes before the skin incision. Group II cases were given the first dose of Inj. cefotaxime and Inj. metronidazole before skin incision and was given oral antibiotics for 7 days. The cases were then monitored for surgical site infections, urine infections and any other febrile illness. Results: There was similar incidence of surgical site infections, febrile illness up to 7 days post-operatively. The difference was non-significant (chi-square test; P<0.05). Conclusion: The study concluded that use of prolonged antibiotic course does not offer any advantage over single dose antibiotic prophylaxis.
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Pharande et al. (2020) conducted an RCT in Caesarean section (n=100). Single dose antibiotic (Cefotaxime and Metronidazole) vs. Multiple dose antibiotic (first dose IV before skin incision + oral antibiotics for 7 days) was evaluated on Surgical incision site infection (wound discharge & superficial dehiscence) (p=0.239). Single dose antibiotic prophylaxis showed no significant difference in surgical site infections (10% vs 4%, p=0.239) compared to a 7-day multiple dose regimen in women undergoing caesarean section.
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