Prescribing practice for antibiotic prophylaxis for cesarean section in a teaching hospital in Brazil.
BACKGROUND
The contribution of antibiotic prophylaxis to reduce surgical wound infection and endometritis after cesarean section is well-known. Despite the knowledge about the effectiveness of antibiotic prophylaxis with this procedure, the administrative regimens are often inappropriate.


METHODS
The use of antibiotic prophylaxis in cesarean section was evaluated in a reference school hospital. Data were collected from medical records, and they correspond to the 9-month observation during 1995 and 1996.


RESULTS
The cesarean section rate was 26.4% in this period. The total procedures observed was 587. Antibiotic prophylaxis was prescribed in 358 procedures (61%). Cephalothin was the most prescribed drug (98.6%), with a regimen of 2 g intravenously after clamping of the umbilical cord and 2 more doses of 1g every 6 hours. Antibiotic prophylaxis was indicated more frequently in patients younger than 30 years and in those with rupture of membranes for more than 6 hours; such differences were significant (P <.05 and P <.00001, respectively).


CONCLUSIONS
The prescribers met the hospital guidelines for antibiotic prophylaxis in only 37.1% of the cesarean sections performed.
D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data*; D001424:Bacterial Infections / Q000517:prevention & control; D001938:Brazil; D002585:Cesarean Section / Q000706:statistics & numerical data; D004334:Drug Administration Schedule; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011247:Pregnancy; D013530:Surgical Wound Infection / Q000517:prevention & control*
D000900:Anti-Bacterial Agents