title: Timing of prophylactic antibiotic at cesarean section: a double-blinded, randomized trial.
abstract: OBJECTIVE
  The purpose was to determine the effect of the timing of prophylactic antibiotics for cesarean section on post-operative infectious complications.
  
  
  METHODS
  This was a prospective, double-blinded, randomized controlled trial in which patients were randomized to receive cefazolin or clindamycin either before skin incision or after cord clamp. The primary outcome was maternal infectious morbidity at 6 weeks postpartum, a composite infectious outcome, which included endometritis, urinary tract infection, wound infection and pneumonia.
  
  
  RESULTS
  Data on 896 women were analyzed; 449 randomized to skin incision, 447 to cord clamp. Postpartum infections were seen in a total of 8.4% of patients. Timing of antibiotic administration did not significantly affect any maternal postpartum infection rates or selected neonatal outcomes.
  
  
  CONCLUSIONS
  Our results suggest that, in a largely non-laboring population, the timing of prophylactic antibiotic administration does not impact post-operative infectious complications of the mother. Despite being one of the largest randomized controlled trials to address this question, our study still lacked sufficient power to make definitive conclusions.
authors.affiliation: Department of Obstetrics and Gynecology, St Vincent Hospital, Indianapolis, IN, USA.
authors.forename: C
authors.initials: C
authors.lastname: Francis
authors.forename: M
authors.initials: M
authors.lastname: Mumford
authors.forename: M L
authors.initials: ML
authors.lastname: Strand
authors.forename: E S
authors.initials: ES
authors.lastname: Moore
authors.forename: E A
authors.initials: EA
authors.lastname: Strand
mesh_terms: D000328:Adult; D019072:Antibiotic Prophylaxis / Q000379:methods*; D002437:Cefazolin / Q000008:administration & dosage; D002585:Cesarean Section / Q000009:adverse effects; D002981:Clindamycin / Q000008:administration & dosage; D004311:Double-Blind Method; D004716:Endometritis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D011446:Prospective Studies; D011645:Puerperal Infection / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D055815:Young Adult
chemical_list: D002981:Clindamycin; D002437:Cefazolin