Comparison of lavage or intravenous antibiotics at cesarean section.
The route of administration of prophylactic antibiotics was studied in a randomized prospective trial. Cefoxitin was administered to high-risk patients at cesarean section by three treatment regimens: intravenous antibiotic (2 g) for eight doses, irrigation of uterus and peritoneum with 2 g of antibiotic, and a combination of intravenous and irrigation as described. A control group received no antibiotic prophylaxis. The incidence of febrile morbidity was similar in each treatment group: intravenous, two of 39 (5%); irrigation, three of 42 (7%); intravenous and irrigation, two of 38 (5%), and were all significantly lower than the control group 14 of 39 (36%) (P less than .05). Similar results were found when prevention of endometritis was the end point: intravenous, two of 39 (5%); irrigation, two of 42 (5%); intravenous and irrigation, two of 38 (5%) compared with 13 of 39 (33%) in the control group (P less than .05). Administration of antibiotics by irrigation is equally effective in preventing postoperative febrile morbidity and endomyometritis as intravenous dosing and a combination of intravenous and irrigation. This affords a potential cost savings.
D000328:Adult; D002440:Cefoxitin / Q000008:administration & dosage*; D002585:Cesarean Section / Q000009:adverse effects; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D004716:Endometritis / Q000517:prevention & control; D005260:Female; D006801:Humans; D007263:Infusions, Parenteral; D011247:Pregnancy; D011292:Premedication / Q000379:methods; D011446:Prospective Studies; D011897:Random Allocation; D012306:Risk; D013530:Surgical Wound Infection / Q000517:prevention & control; D007507:Therapeutic Irrigation
D002440:Cefoxitin