Women undergoing caesarean section have an increased risk of postoperative infection and infectious morbidity compared with women giving birth vaginally. Infectious morbidity for the mother, consisting primarily of endomyometritis and wound infection remains a leading cause of post-operative complications. Prophylactic antibiotics are expected to work in conjunction with the antiseptic measures taken before and during surgery. Present comparative study was conducted between injection Ceftriaxone single dose versus routine 5 day course of ampicillin and metronidazole in elective caesarean delivery patients at a tertiary care center.
Material and Methods: This comparative, prospective, hospital based study was conducted in the department of Gynaecology and Obstetrics, in patients posted for elective LSCS, BMI < 30, willing to participate in study & follow up for 3 months. Patients were randomly divided in 2 groups each consisted of 100 patients as Group A patients received injection Ceftriaxone 1gm. intravenous stat at the time of induction of anesthesia &Group B - patients received intravenous ampicillin and metronidazole for 1 day followed by oral for next 4 days.
Results: Mean age was 23.9±3.8 years in group A & 23.1±3.4 years in group B. BMI at the time of admission was 28.5±6.7 kg/m² & 29.1±5.9 kg/m² in group A & B respectively. Mean duration of surgery was 44.1±7.1 min in group A & 45.2±5.7 in group B. Average blood loss in both groups was comparable. Mean days of hospitalisation was 4.3±3.7 days & 5.1±2.9 days in group A & B respectively. History of previous laparotomy like LSCS, ectopic surgery, etc. was present in 37 & 31 patients from group A & B respectively. Fever was most common morbidity noted (Group A–5 & Group B-4) followed by urinary tract infection (Group A – 3 & Group B -4), wound infection, endometritis & early neonatal sepsis. Statistical difference between group A & B was non-significant for all morbidities. One patient from each group required resuturing. No mortality was noted in present study.
Conclusion: This study shows single dose antibiotic prophylaxis is as effective as conventional multi dose antibiotic therapy. It is cost effective, antibiotic resistance of microorganisms can be prevented, reduces patient side effects, nursing staff work.