Comparison of Short Course with Long Course Antibiotic Prophylaxis for Caesarean Section: A Randomized Controlled Study

Abstract

Comparison of Short Course with Long Course Antibiotic Prophylaxis for Caesarean Section: A Randomized Controlled Study.

ABSTRACT

Background: Antibiotic prophylaxis in caesarean section is intended to prevent post-partum infectious morbidity and mortality associated with the procedure. Judicious use of prophylactic antibiotics also reduces the incidence of adverse drug reactions and antibiotic resistance. Although there are guidelines and recommendations for the duration of antibiotic prophylaxis for caesarean section, these are often not adhered to in most healthcare facilities.

Objective: This study compares the efficacy of short-course antibiotic prophylaxis with long-course prophylaxis in caesarean section. 

Methodology: This was a randomized controlled study in which 200 pregnant women undergoing elective or emergency caesarean section were enrolled into two groups of 100 women each (Group A: short course antibiotics and Group B: long course antibiotics), and monitored for 6 weeks for evidence of febrile morbidity, urinary tract infection, wound infection, and clinical endometritis. The secondary outcome measures were the cost of antibiotics and hospital care.

Results: There was no statistical difference in the incidence of wound infection (3% vs 1%, p-value 0.31, and urinary tract infection (0% vs 1%, p-value 0.32) in the short and long-course antibiotic groups respectively. The cost of antibiotics and hospital care was significantly higher in long course antibiotic group (p-value< 0.001)

Conclusion: Short-course prophylactic antibiotic prophylaxis has comparable efficacy and is more cost-effective than long-course prophylactic antibiotics in preventing post-caesarean section infectious morbidities.

Keywords:   Prophylactic antibiotics, caesarean section, infectious morbidity, post-operative