Antimicrobial Prophylaxis for Caesarean Delivery; A comparative study between different agents

Abstract

Antimicrobial prophylaxis is commonly used for pre-intra and post-operative caesarean delivery. Caesarean delivery is still the single most important risk factor for puerperal infection. Post-caesarean infections include wound infections, endomyometritis, bacteraemia, septic shock, septic pelvic vein thrombophlebitis, necrotising fasciitis, pelvic abscess, dehiscence of the wound or evisceration. The goal of antimicrobial prophylaxis is to put a stop to postoperative infection of the surgical site, the use of therapeutic antibiotics, additional surgical interventions, longer duration of hospital stay, to decrease postoperative infectious morbidity and mortality and the cost of postoperative health care. A post-caesarean wound infection detected prior to hospital discharge will lead to prolongation of hospital stay and will increase the hospitalisation costs and need of readmission. Both the American College of Obstetricians and Gynaecologists and the American Society of Health-Care System Pharmacists have introduced single-dose prophylactic protocols using a heterogeneity of agents (penicillins, cephalosporins, clindamycin and azithromycin). Women undergoing caesarean delivery have a greater risk of developing infection compared to women who have a vaginal birth by 5 to 20-fold. The use of prophylaxis in patients undergoing a low-risk Caesarean Delivery remains controversial.