Perioperative use of cefoxitin in primary cesarean section.
We performed a randomized, double-blind trial on a relatively low-risk population comparing the use of three doses of cefoxitin vs. placebo in the prevention of infection following primary cesarean section. Major site-related morbidity (endometritis, wound infection and septicemia) was significantly reduced in the cefoxitin group (8.9% vs. 27.8%; p = 0.017). Febrile morbidity alone tended to occur in the cefoxitin group (15.6% vs. 3.7%; p = 0.091), and all five urinary tract infections occurred in the cefoxitin group as well. Total morbidity was therefore not significantly different (cefoxitin, 35.6%; placebo, 31.5% [not significant]). Duration of hospitalization (mean, 6.0 days) and need for further postoperative antibiotic therapy were similar in the two groups. Our study demonstrated a modest benefit from the perioperative use of antibiotics in relatively low-risk patients undergoing primary cesarean section. Issues that need further study include definition of the optimal prophylactic regimen and of high-risk populations for whom prophylaxis would be most helpful.
D000328:Adult; D002440:Cefoxitin / Q000627:therapeutic use*; D002585:Cesarean Section; D002986:Clinical Trials as Topic; D004311:Double-Blind Method; D004716:Endometritis / Q000453:epidemiology; D005260:Female; D005334:Fever / Q000453:epidemiology; D006801:Humans; D010919:Placebos; D011183:Postoperative Complications / Q000453:epidemiology; D011247:Pregnancy; D011292:Premedication; D018805:Sepsis / Q000453:epidemiology; D013530:Surgical Wound Infection / Q000453:epidemiology; D014552:Urinary Tract Infections / Q000453:epidemiology
D010919:Placebos; D002440:Cefoxitin