Prophylactic Antibiotics in Elective Caesarean Section (Ceftriaxone versus Triple)

Abstract

The caesarean section is associated with a high incidence of postoperative infections, which may lead to increased risk of maternal mortality. The antibiotic prophylaxis may reduce these infectious complications. This is a prospective randomized controlled clinical trial conducted to evaluate the effect of antibiotic prophylaxis in decreasing the frequency of postoperative infection after scheduled elective caesarean section, and to compare prophylactic efficacy and safety of the third generation cephalosporin (Ceftriaxone), a single dose (one gram), preoperatively (study group = 100 patients) versus triple antibiotics (Metronidazole, Gentamycin and Ampicillin + Cloxacillin) three doses within the first 24 hours beginning at the start of operation (control group = 100 patients). It was performed at Wad Medani Teaching Hospital from January to June 2001. The two groups were randomly selected and well-matched and they were followed up postoperatively for evidence of infectious complications. T. and chi-squared tests statistical analysis were applied where appropriate with P. value <0.05 considered significant for comparison between the two groups. There were no statistically significant differences in demographic features, obstetric parameters and risk factors for infection between them. The main results of the study were as follows: The endomyometritis was 2% in the study group and 1% in the control group. The wound infection was 1% in the study group and 2% in the control group. The infection -related complication was 1% in each group. The other febrile morbidity was 3% in the study group and 2% in control group. The statistical analysis did not show significant differences between the two groups. Both regimens were well tolerated by the patients, and the postoperative hospital stsy, and the effect on the newborn and the cost were almost the same with no statistically significant differences between them. Therefore, it was considered that single dose of Ceftriaxone is better because it is safe and effective and its application is easier and with less financial cost.