Ampicillin/sulbactam versus ampicillin alone for cesarean section prophylaxis: a randomized double-blind trial.
To study the effectiveness of anaerobic coverage in prevention of postpartum endometritis in women undergoing nonelective cesarean sections, we conducted a randomized prospective double-blind study of women undergoing cesarean sections and requiring antibiotic prophylaxis from April 1, 1989, through December 31, 1990. Ninety-four patients were enrolled in the study. Forty-five patients received ampicillin alone and 46 received ampicillin in conjunction with sulbactam. All patients were evaluated prior to surgery and in the postoperative period. Ninety-one patients completed the study and their records were analyzed. Patients were divided into two groups depending on the presence or absence of ruptured membranes. Seventy-five percent of patients had ruptured membranes. Failure of prophylaxis and subsequent endometritis was documented in 8.8% of patients who received ampicillin and sulbactam and 35.3% of patients who received ampicillin alone. This difference was statistically significant (p < 0.02). In conclusion, single-dose ampicillin and sulbactam provides better prophylaxis than single-dose ampicillin in women undergoing cesarean section with rupture of membranes.
Rijhsinghani
A
A
Francis Scott Key Medical Center, Franklin Square Hospital, Baltimore, Maryland, USA.
Savopoulos
S E
SE
Walters
J K
JK
Huggins
G
G
Hibbs
J R
JR
D000328:Adult; D000667:Ampicillin / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D002585:Cesarean Section; D004311:Double-Blind Method; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011446:Prospective Studies; D013407:Sulbactam / Q000627:therapeutic use
C035444:sultamicillin; D000667:Ampicillin; D013407:Sulbactam