Women undergoing cesarean delivery are 5-20 fold greater risk of infection than women undergoing vaginal delivery. Infectious complications after cesarean delivery are an important cause of maternal morbidity, increase in hospital stay and cost of treatment. The use of antibiotic prophylaxis for cesarean section can reduce the incidence of postoperative infectious morbidity.
Material and Methods: This was a prospective case control study involving 140 women undergoing cesarean delivery for various indications, who were divided into two groups, Group A and B with 70 patients in each which was conducted at Maharajah’s Institute Of Medical sciences, vizianagaram, Andhra Pradesh for duration of 1 year. Group A received antibiotic prophylaxis of ceftriaxone 1gm IV 30 minutes before skin incision and another dose at 24 hours, Group B received Ceftriaxone 1gm IV 30 minutes before cesarean section, followed by Ceftriaxone 1gm+ Metronidazole 100ml IV 8th hourly for 48 hours followed by oral cefixime till suture removal. Postoperatively, both groups of patients were followed up for febrile and infectious morbidity and neonatal outcome was followed during hospital stay for infectious morbidity.
Results: Total of 140 patients were analysed in both groups of 70 patients in each. Baseline characteristics like age, parity, gestational age, socioeconomic status, were similar in both groups. Postoperative morbidities like Febrile morbidity and surgical site infection (p=0.8) did not differ significantly. The neonatal infectious morbidity in both groups (p=0.66) and recovery was uneventful. Conclusion: Double dose of single antibiotic regimen was equally effective as compared to multiple doses of multiple drugs and extended antibiotic therapy. We can cut down on antibiotic misuse among parturients which has implications in global emergence of antibiotic resistant bacteria and epigenetic and allergic diseases in the offspring.