Timing of prophylactic antibiotic administration in the uninfected laboring gravida: a randomized clinical trial.
OBJECTIVE
The purpose of this prospective study was to determine whether the timing of prophylactic antibiotics at cesarean delivery influences maternal/neonatal infectious morbidity.


METHODS
In this double-blind placebo-controlled trial, cefazolin was given at skin incision (group A) or at cord clamping (group B). Patients were eligible for the trial if they had labored and required a cesarean delivery.


RESULTS
Over a 30-month period 303 patients with singleton pregnancies entered the trial; 153-group A, 149-group B. Demographics, indication for cesarean delivery (P = .54), and operative time (P = .999), as well as rates of endometritis (RR 0.67, 95% CI 0.42-1.07), wound infection (RR 0.84, 95% CI 0.45-1.55), neonatal sepis (RR 1.28, 95% CI 0.91-1.79), and NICU admissions (RR 1.28, 95% CI 0.91-1.79) were similar between the 2 groups.


CONCLUSIONS
There was no difference in maternal infectious morbidity whether antibiotics were given before skin incision or at cord clamping.
Thigpen
Brad D
BD
Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, USA.
Hood
W Ashley
WA
Chauhan
Suneet
S
Bufkin
Laura
L
Bofill
James
J
Magann
Everett
E
Morrison
John C
JC
D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis; D002585:Cesarean Section / Q000379:methods*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007743:Labor, Obstetric; D011247:Pregnancy; D011446:Prospective Studies; D011645:Puerperal Infection / Q000517:prevention & control*; D013530:Surgical Wound Infection / Q000517:prevention & control; D013997:Time Factors; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents