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Name | Evaluation of antibiotic prophylaxis in cesarean section: Single shot, double shot and extended regimes |
Description | Research article:- Obstetrics & Gynaecology Abhilasha Gupta1, Aruna Verma2* & Ketaki Harit3 Professor & Head1,Lecturer2,Junior Resident3,Department of Obstetrics & Gynaecology, LLRM Medical College, Meerut,India.
Abstract:- Aims & objectives: Comparison of febrile and infectious morbidity, incidence of serious post-operative complications,maternal side-effects of drug therapy and cost-effectiveness of single shot, double shot and extended antibiotic prophylaxis in cesarean section. Materials and methods: Patients were randomly allocated to three different groups. Group A patients were administered single shot of broad-spectrum antibiotics pre-operatively, within 30 minutes before starting the surgery. Group B patients were given a loading dose of antibiotics pre-operatively and another dose 12 hours later. Group C patients were administered antibiotics upto the 7th post-operative day. Results & conclusion: There was no significant difference in terms of fever, post-operative infectious morbidity, and wound gaping or mean duration of hospital stay in the three regimes. There was a significant difference in side-effects of drug therapy between the three groups; maximum side-effects being seen in patients kept on extended antibiotic regime (p<0.001). Cost of treatment was minimum in single shot regime and maximum in extended regime (p<0.001). Single shot antibiotic prophylaxis can thereby be safely used instead of prolonged antibiotic therapy in patients undergoing cesarean section. There is significant improvement in maternal comfort level and reduction in cost of treatment without any increase in risk of post-operative complications.
Keywords:- Antibiotic prophylaxis, Cesarean section, Single shot. References:- 1.Gibbs RS. Clinical risk factors for puerperal infection. Obstetrics and Gynecology 1980; 55 : 1785-835. 2.Henderson E, Love EJ. Incidence of hospital acquired infections associated with caesarean section, Journal of Hospital Infection 1995; 29: 245-55. 3.Leigh DA, Emmanuel FX, Sedgwick J, Dean R, Post-operative urinary tract infection and wound infection in women undergoing caesarean section : a comparison of two study periods in 1985 and 1987. Journal of Hospital infection 1990, 15: 107-16. 4.Boggess KA, Watts DH, Hillier SL, Krolm MA, Benedetti TJ, Eschenback DA. Bacteremia shortly after placental separation during cesarean delivery. Obstetrics and gynecology 1996; 87: 779-84. 5.Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for prevention of surgical site infection, 1999. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee. Am J Infect Control 1999; 27:97–134. 6.Shah S,Mazher Y, John IS. Single or triple dose piperacillin prophylaxis in elective cesarean section. International Journal of Gynecology and Obstetrics 1998; 62(1):23–9. 7.Patacchiola F, Di Paolantonio L, Palermo P, Di Stefano L, Mascaretti G, Moscarini M. Minerva Ginecol. 2000 Oct; 52(10):385-9. 8.D’Angelo LJ, Sokol RJ. Short-Versus long course prophylactic antibiotic treatment in caesarean section patients. Obstet Gynaecol. 1980; 55: 583-6. 9.Scarpignato C, Caltabiano M. Condemi V. Short-term vs Long-term cefuroxime prophylaxis in patients undergoing emergency caesarean section. Clin Ther 1982; 5:186-91. 10.Roex AJM, Van Loenen AC, Puyenbroek JI, Arts NFT. Secretion ofcefoxitin in breast milk following short-term prophylactic administration in caesarean section. European Journal Obstetrics, Gynecology and Reproductive Biology 1987; 25:299–302.
Copyright © 2013 Abhilasha Gupta, Aruna Verma & Ketaki Harit. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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