Effectiveness of oral versus parenteral antibiotics in cesarean section: an observational study

Authors

  • Malini Bharadwaj Department of Obstetrics and Gynecology, L.N. Medical College and J.K. Hospital, Bhopal, Madhya Pradesh, India
  • Rani R. Momaya Department of Obstetrics and Gynecology, L.N. Medical College and J.K. Hospital, Bhopal, Madhya Pradesh, India
  • Rituja Kaushal Department of Obstetrics and Gynecology, L.N. Medical College and J.K. Hospital, Bhopal, Madhya Pradesh, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20205766

Keywords:

Caesarean section, Single dose antibiotic prophylaxis, Wound infection

Abstract

Background: Women undergoing caesarean section are associated with high rates of post-operative infections, which causes significant rise in infectious morbidity, duration of hospital stay and cost treatment. Implementation of appropriate antibiotic prophylaxis is desirable to prevent these complications. We aimed to observe the outcome of Intravenous single dose antibiotic prophylaxis pre-operatively followed by oral antibiotics post-operatively, in comparison to other group with multiple dose Intravenous antibiotic prophylaxis post-operatively.

Methods: An observational study conducted in the department of obstetrics and gynaecology, L.N.M.C and J.K. Hospital, Kolar Road, Bhopal, on patients undergoing Elective or Emergency Lower segment caesarean section (LSCS) for a period of 6 months, on 100 subjects, with 50 participants in each group. Null hypothesis was invalidated by statistically analysing the data using chi square test, Unpaired t-test and odds ratio.

Results: Prevalence of c-section was more in 25-31year age group. Abnormal presentation was the most common indication for elective LSCS in both the groups (8%), non-progress of labour and foetal distress was the most common indication for emergency LSCS in group A and B respectively (10%). There was statistically insignificant difference in the occurrence of post-operative complications in both the groups (chi sq. value=0.4285, p value=0.5127) with overall, most common complication was febrile morbidity (8% vs.12%). Significant difference noted in total bed occupancy days (unpaired t-test 1.9844) (p-value.0.000000049<0.05%).

Conclusions: We recommend the use of cost-effective single dose antibiotic prophylaxis in prevention of post-operative infectious morbidity in women undergoing caesarean section.

Author Biography

Rani R. Momaya, Department of Obstetrics and Gynecology, L.N. Medical College and J.K. Hospital, Bhopal, Madhya Pradesh, India

3rd year obs & gynae resident.

References

Dlamini LD, Sekikubo M, Tumukunde J. Antibiotic prophylaxis for caesarean section at a Ugandan hospital: a randomised clinical trial evaluating the effect of administration time on the incidence of postoperative infections. BMC Pregnancy Childbirth. 2015;15:91.

Shah Z, Kshirsagar NS, Shah S. Comparison of single dose prophylactic antibiotics versus five days antibiotic in cesarean section. J Evolution Med Dental Sci. 2014;3(12):24.

Mugisa GA, Kiondo P, Namagembe I. Single dose ceftriaxone and metronidazole versus multiple doses for antibiotic prophylaxis at elective caesarean section in Mulago hospital: a randomized clinical trial version 1; peer review: 1 approved, 1 approved with reservations. Available at https://doi.org/10.12688/aasopenres.12849.1. Accessed on 02 September 2020.

Brown J, Thompson M, Sinnya S. Pre-incision antibiotic prophylaxis reduces the incidence of post-caesarean surgical site infection. J Hosp Infect. 2013;83(1):68-70.

Mohan J, Thangaroja T, Menon M. Single dose antibiotic prophylaxis in elective obstetric and gynaecological surgeries-a descriptive study. Int J Reprod Contracept Obstet Gynecol. 2017;6:3897-02.

Kumari R, Sharma A, Sheetal, Roy P, Anupriya. To study the effectiveness of prophylactic use of ceftriaxone (single dose) in caesarean section in low risk patients in a tertiary care center, Moradabad, India. Int J Res Med Sci. 2017;5:5278-82.

New WHO guidance on prevention and treatment of maternal peripartum infections. Available at http://dx.doi.org/10.1016/ S2214-109X(15)00213-2. Accessed on 29 September 2015.

WHO recommendation on routine antibiotic prophylaxis for women undergoing elective or emergency caesarean section (September 2015). The WHO Reproductive Health Library; Geneva: World Health Organization. Available at https:// extranet. who. int/ rhl/ topics/ preconception-pregnancy-childbirth- and- postpartum- care/who-recommendation- antibiotic- prophylaxis- caesarean-section-using-single-dose-first-generation. Accessed on 20 August 2020.

WHO recommendation on antibiotic prophylaxis for caesarean section using a single dose of first generation cephalosporin or penicillin in preference to other classes of antibiotics (September 2015). The WHO Reproductive Health Library; Geneva: World Health Organization. Available at https://extranet.who.int/rhl/topics/preconception-pregnancy-childbirth-and-postpartum-care/who-recommendation-antibiotic-prophylaxis-caesarean-section-using-single-dose-first-generation Accessed on 20 August 2020.

Committee on Practice Bulletins-Obstetrics. ACOG Practice Bulletin No. 199: Use of prophylactic antibiotics in labor and delivery. Obstet Gynecol. 2018;132(3):103-19.

Prathima S, Savitha C, Tejeswini KK, Anitha GS. Comparative study of single dose versus multiple doses of antibiotic prophylaxis in caesarean delivery. Int J Reprod Contracept Obstet Gynecol. 2017;6:215-8.

Shaheen S, Akhtar S. Comparison of single dose versus multiple doses of anitibiotic prophylaxis in elective caesarian. J Postgrad Med Inst. 2014;28(1):83-6.

Ansari N, Das C, Ansari M. Evaluation of prophylactic antibiotic in caesarean section. J Nepalgunj Med College. 2015;12(2):40-1.

Kamilya, Gourisankar. A randomized controlled trial comparing two different antibiotic regimens for prophylaxis at cesarean section. J Obst Gynaecol India. 2012;62(1):35-8.

Francis C, Mumford M, Strand M. Timing of prophylactic antibiotic at cesarean section: a double-blinded, randomized trial. J Perinatol. 2013;33:759-62.

Smaill FM, Grivell RM. Antibiotic prophylaxis versus no prophylaxis for preventing infection after cesarean section. Cochrane Database Syst Rev. 2014;(10):CD007482.

Martin EK, Beckmann MM, Barnsbee LN, Halton KA, Merollini K, Graves N. Best practice perioperative strategies and surgical techniques for preventing caesarean section surgical site infections: a systematic review of reviews and meta-analyses. BJOG. 2018;125(8):956-64.

Vathana M, Muhunthan K. A randomized control trial of single dose versus multiple doses of IV antibiotic prophylaxis in caesarean delivery. Sri Lanka J Obst Gynaecol. 2018;40(4):92-100.

Lopes, Rui, Pinto S, Bernardo, Azevedo, Luís. Single dose versus multiple dose of antibiotic prophylaxis in caesarean section: a systematic review and meta-analysis. Int J Obst Gynaecol. 2016;124:10-4.

Downloads

Published

2020-12-26

Issue

Section

Original Research Articles