Antibiotic prophylaxis in cesarean sections: a tertiary care hospital based survey
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20212151Keywords:
Antibiotics, Prophylactic antibiotics, Cesarean section, Indian settingsAbstract
Background: The objective of the study was to study the pattern of prophylactic antibiotics usage in caesarean sections in Indian settings.
Methods: A cross-sectional observational study was done on women undergoing elective and emergency caesarean sections in the Department of obstetrics and gynecology who were given antibiotics according to the existing trends in the hospital.
Results: Almost 72% women received prophylactic antibiotics within 30-60 minutes of skin incision while rest 28% received it before 60 minutes. In post-operative period around 80% of the women received injectable antibiotics for 48 hours, 12% for 72 hours and rest 8% received antibiotics for more than 72 hours. 90% of the patients received injections ceftriaxone 1 gm IV BD, gentamycin 80 mg IV BD metronidazole 400 mg iv TDS while 10% received injection Ampicillin 500 mg QID along with Injection Metronidazole 400 mg iv TDS and injection gentamycin 80 mg IV BD. Two percent of the cases developed wound sepsis and required change to higher antibiotics.
Conclusions: In spite of recommendations by International Guidelines for single dose of prophylactic antibiotics, multiple doses are being given. There are no Indian guidelines for antibiotic prophylaxis in cesarean sections and as a result, various combinations of antibiotics are being given for variable duration leading to antibiotic resistance and increased cost of treatment.
References
Say L, Chou D, Gemmill A, Tuncalp O, Moller AB, Daniels J et al. Global causes of maternal death: a WHO systematic analysis. Lancet Global Health. 2014; 2:e323-33.
Khan KS, Wojdyla D, Say L, Gulmezoglu AM, Van Look PF. WHO analysis of causes of maternal death: a systematic review. Lancet.2006;367:1066-74.
Gibbs RS. Clinical risk factors for puerperal infection. ObstetGynecol .1980;55:18S-4S.
Bastu E, Gulmezoglu AM. Antibiotic prophylaxis versus no prophylaxis for preventing infection after caesarean section: RHL commentary. The WHO Reproductive Health Library; Geneva: World Health Organization.
WHO Recommendations for Prevention and Treatment of Maternal Peripartum Infections. Geneva: World Health Organization. 2015.
Liu R, Lin L, Wang D. Antimicrobial prophylaxis in caesarean section delivery. Exp Ther Med. 2016;12(2):961-4.
Emmons SL, Krohn M, Jackson M, Eschenbach DA. Development of wound infections among women undergoing cesarean section. Obstet Gynecol. 1988;72:559-64.
Roberts S, Maccato M, Faro S, Pinell P. The microbiology of post-cesarean wound morbidity. Obstet Gynecol. 1993;81:383-6.
Andrews WW, Shah SR, Goldenberg RL, Cliver SP, Hauth JC, Cassell GH. Association of post-cesarean delivery endometritis with colonization of the chorioamnion by Ureaplasma urealyticum. Obstet Gynecol. 1995;85:509-14.
