Chemoprophylaxis in caesarean section

ABSTRACT

To determine the usefulness of two different regimens of antibiotics on post caesarean infectious morbidities. A comparative study drug trial. Department of Obstetrics and Gynaecology Lyari General Hospital and private hospitals of Karachi, from January 2009 to June 2009. Patients who underwent caesarean section were recruited. The patient were divided into two groups of 74 each. Group A received triple antibiotic therapy including injection cephradine, aminoglycoside and metronidazole for first 48 hours. Followed by oral therapy for 5 days. Group B received injection ceftriaxone and metronidazole for first 48 hours followed by oral therapy for 5 days. In both groups therapy was started before skin incision. Those who had established infection prior to surgery or who received antibiotics in last 24 hours or allergic to any of the infection prior to surgery or who received antibiotics in last 24 hours or allergic to any of the antibiotics used, were excluded. Patients were assessed post operatively for infectious complications including febrile illness, dysuria, offensive lochia and abdominal wound infection. No significant difference was found between the two groups. Complications found were febrile morbidity [23.0% Vs 18.7%], urinary tract infection [13.3% Vs 16.0%] wound infection [14.7% Vs 10.7%] and lochia [6.7% Vs 8.0%] respectively in Group A and Group B. There was a significant difference in terms of cost effectiveness of 3[rd] generation cephalosporin that was more. Both first and third generation cephalosporins are equally effective in caesarean section as prophylaxis