title: Antibiotic prophylaxis at elective cesarean section: a randomized controlled trial in a low resource setting.
abstract: OBJECTIVE
  To determine the best time to administer prophylactic antibiotics at Cesarean delivery in order to reduce the postoperative maternal infectious morbidity in a low resource setting.
  
  
  METHODS
  One hundred term primigravidae with singleton pregnancy were recruited and randomly allocated to two equal groups. Each woman received 2 g intravenous Cefazoline. Women in Group I received it prior to skin incision while those in Group II had it immediately after cord clamping. We measured the following outcome parameters: (1) Surgical site wound infection; (2) Endometritis and (3) Urinary tract infection.
  
  
  RESULTS
  There was no significant difference in any of the patients' characteristics between both groups. In Group I, three cases developed surgical site infections but four in Group II (p > 0.05). In Group I, the infected cases had Cesarean because of malpresentations while in Group II, two cases had Cesarean because of patients' request, one because of maternal heart disease and one due to intra-uterine growth restriction. Seven and nine cases had urinary tract infection in Groups I and II, respectively, (p > 0.05).
  
  
  CONCLUSIONS
  Prophylactic antibiotic administration either prior to surgery or after cord clamping is probably equally effective in reducing the postoperative infectious morbidity after Cesarean in low resource settings.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine-Menofyia University , Shibin Elkom , Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Kandil
authors.forename: Zakaria
authors.initials: Z
authors.lastname: Sanad
authors.forename: Wael
authors.initials: W
authors.lastname: Gaber
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000191:economics; D002437:Cefazolin / Q000191:economics / Q000627:therapeutic use*; D002585:Cesarean Section / Q000009:adverse effects / Q000191:economics / Q000706:statistics & numerical data; D017558:Elective Surgical Procedures / Q000191:economics / Q000706:statistics & numerical data; D004716:Endometritis / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D006295:Health Resources; D006801:Humans; D011203:Poverty; D011247:Pregnancy; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000517:prevention & control; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D002437:Cefazolin