Comparison of ceftriaxone versus triple drug regimen in the prevention of cesarean section infectious morbidities.
OBJECTIVE
To compare the effectiveness of single dose ceftriaxone versus multiple doses of ampiclox, gentamicin, and metronidazole to prevent infectious morbidity at elective cesarean section.


METHODS
This was a randomized clinical trial involving 200 pregnant women who had an elective cesarean section for various reasons during the study period. Outcome measures included endometritis, urinary tract infections, febrile morbidities, wound infections, duration of hospital stay, and cost of antibiotic therapy. Data were managed using SPSS.


RESULTS
There was no statistically significant difference in the mean duration of hospital stay between the two groups, but a significant statistical difference was found in the mean cost of antibiotic treatment ($15 for the combination and $9 for ceftriaxone; p = 0.000), with the group of patients taking a single dose of ceftriaxone (ROPHEX) having a lower mean cost of treatment than those taking a combination of ampiclox, gentamicin, and metronidazole. The study groups did not differ significantly in the incidence of endometritis (14% versus 15%), urinary tract infection (11% versus 15%), wound infections (7% versus 8%), febrile morbidity (7% versus 6%), and peritonitis (0% versus 0%).


CONCLUSIONS
Single dose ceftriaxone was as effective as a combination of ampiclox, gentamicin, and metronidazole in preventing post-elective cesarean section complications.
Alekwe
L O
LO
Department of Obstetrics and Gynaecology, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria.
Kuti
O
O
Orji
E O
EO
Ogunniyi
S O
SO
D000328:Adult; D000667:Ampicillin / Q000008:administration & dosage / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000191:economics / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D002443:Ceftriaxone / Q000008:administration & dosage* / Q000191:economics / Q000627:therapeutic use; D002585:Cesarean Section / Q000401:mortality*; D003023:Cloxacillin / Q000008:administration & dosage / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004716:Endometritis / Q000209:etiology; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008795:Metronidazole / Q000008:administration & dosage / Q000627:therapeutic use; D011247:Pregnancy; D011645:Puerperal Infection / Q000191:economics / Q000209:etiology / Q000517:prevention & control*; D013530:Surgical Wound Infection / Q000191:economics / Q000209:etiology / Q000517:prevention & control*; D014552:Urinary Tract Infections / Q000209:etiology
D000900:Anti-Bacterial Agents; D005839:Gentamicins; D008795:Metronidazole; C016828:Viccillin S (combination); D002443:Ceftriaxone; D000667:Ampicillin; D003023:Cloxacillin