A survey of obstetricians' practice of using prophylactic antibiotics in vaginal deliveries and caesarean sections.

ABSTRACT

Antibiotics are prescribed in pregnancy but only few reports provide information about the actual practice of prophylactic antibiotics usage in various obstetrical conditions amongst obstetricians. The present study evaluates the practice of obstetricians of Delhi regarding prescription of antibiotics in vaginal deliveries and caesarean sections. The open-ended predesigned questionnaire study incorporated details of the obstetricians working in different hospitals of Delhi and their practice of prescribing antibiotics in vaginal deliveries, episiotomies and caesarean sections was filled by obstetricians. The data was analysed using Student's 't' test and Chi-square test. The mean age of obstetricians was 35.5 years; 90% were females and 48.9% were postgraduate students with 70% less than 5 years experience and 77.8% were working in a government hospital. In episiotomy, 18.9% obstetricians did not use antibiotics while 33.3%, 27.8% and 20% obstetricians used ampicillin, amoxicillin and cephalexin orally for 5 days respectively. Injection cefazolin was used intravenously, 1 g 12 hourly for 3 days by 34.4% and 33.3% obstetricians in elective and emergency caesarean sections respectively, while it was used for 5 days by 35.5% and 41.1% obstetricians respectively. A combination of ampicillin, gentamicin and metronidazole for 5 days was used by 30% and 25.5% obstetricians for elective and emergency caesarean sections respectively. In spite of clear evidence from Cochrane Database of Clinical Reviews that use of penicillin or first generation cephalosporins in single dose therapy is effective; the actual practice is contrary with use of multiagent antibiotics for long periods, being very rampant in actual clinical practice.