Effectiveness of Pre-incisional Amoxicillin-Clavulanic Acid in Preventing Post-Caesarean Wound Infection at Aminu Kano Teaching Hospital, Kano

Abstract

Background: Postoperative wound infection is a recognised complication of caesarean section with a substantial burden to the health system. It may result in prolonged period of hospitalization and health implications. Prevention of such infections should be a health care priority especially in developing countries.

Objectives: To evaluate the effectiveness of a pre-incisional administration of amoxicillin-clavulanic acid in the prevention of post caesarean wound infection in our hospital.

Material and Methods: This was a prospective randomised controlled study of 404 women who were to have an emergency Caesarean section. Women in the study group received a single dose of 1.2g amoxicillin-clavulanic acid preoperatively, in addition to the usual postoperative antibiotic prescription used in the department. Women in the control group received only postoperative prophylactic antibiotics. They were monitored for features of wound infection, endometritis, and the duration of hospital stay.

Results: The rate of wound infection was 18.8% in the control group and 11.5% in the study group (RR 0.68, 95% CI 0.47-0.99, P 0.04). The rates of endometritis in the control and study groups were 13.5% and 5.8% respectively (RR 0.57, 95% CI 0.35-0.95, P 0.01). The length of hospital stay in the study group was 139.0 (± 24.81) hours while in the control group it was 151.4 (± 38.28) hours (P <0.01).

Conclusion: There was a significant reduction in the rates of wound infection and endometritis and a shorter duration of hospital stay when the pre-incisional antibiotic was given to patients who were to undergo emergency Caesarean section.