A study on prophylactic antibiotics in cesarean sections--is it worthwhile?
BACKGROUND
To study the effect of single-dose prophylactic Augmentin on patients undergoing cesarean section.


METHODS
Three hundred and twenty women undergoing cesarean section were randomized into two groups in a prospective, double-blind, placebo-controlled study. One hundred and sixty women were allocated to receive a single-dose of 1.2 g Augmentin at induction of anesthesia and 160 were allocated to a control group who received placebo. The following post-cesarean outcome parameters were compared between the two groups: duration of hospital stay, febrile morbidity, urine microscopy, bacteriuria, endometritis, and wound infection.


RESULTS
There was no significant difference between the two groups with respect to the duration of post-operative hospital stay or the incidence of febrile morbidity, endometritis, and wound infection. However, the study group had fewer post-operative abnormalities in urine microscopy (p < 0.05) and bacteriuria (p < 0.01). The bacterial flora were also different between the two groups.


CONCLUSIONS
Single-dose prophylactic Augmentin did not produce any clinically significant improvement in the post-operative course of patients undergoing cesarean section. If proper surgical techniques are followed in association with closed rectus sheath drainage, it is unlikely that any trial of antibiotics will be able to demonstrate any clinically significant outcome.
Yip
S K
SK
Department of Obstetrics and Gynaecology, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.
Lau
T K
TK
Rogers
M S
MS
D000658:Amoxicillin / Q000008:administration & dosage*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002585:Cesarean Section; D019818:Clavulanic Acid; D002969:Clavulanic Acids / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D010406:Penicillins / Q000008:administration & dosage*; D010919:Placebos; D011247:Pregnancy; D011300:Preoperative Care; D013530:Surgical Wound Infection / Q000517:prevention & control
D000900:Anti-Bacterial Agents; D002969:Clavulanic Acids; D010406:Penicillins; D010919:Placebos; D019818:Clavulanic Acid; D000658:Amoxicillin