Effectiveness of single versus multiple doses of antibiotics in elective cesarean section for prevention of post operative morbidity

Authors

  • Bhavya Kodanda Rama Department of Obstetrics and Gynecology, S. N. R. District Hospital, Kolar, Karnataka, India
  • Narayana Swamy Mariyappa Department of Obstetrics and Gynecology, S. N. R. District Hospital, Kolar, Karnataka, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20242500

Keywords:

Antibiotic prophylaxis, Caesarean section, Ceftriaxone

Abstract

Background: Caesarean section is one of the commonest major abdominal surgeries worldwide given to its increasing rate. The most common post-operative complication following caesarean section is considered as the infective morbidity. Many studies have shown a clear advantage of antibiotic prophylaxis in the reduction of postoperative infective morbidity. However, indiscriminate use of antibiotics is still being continued in many centres. This study was aimed at comparing the efficacy of single versus multiple doses of antibiotics in preventing postoperative morbidity following Elective caesarean section.

Methods: This was a prospective comparative study that included 200 patients undergoing elective caesarean section at SNR District Hospital, Kolar, during the study period. These patients were divided into two groups, group 1 received single dose of Inj ceftriaxone 2gm I/V and group 2 received a single dose of Inj ceftriaxone 1 gm I/V within 30-60 mins of commencement of surgery followed by Inj ceftriaxone 1gm I/V BID for 5 days post-operatively. Patients were followed up prospectively for the development of infective morbidity in the form of surgical site infections.

Results: Mean age, mean haemoglobin levels, and duration of surgery were comparable in patients with SSI in both groups. The incidence of surgical site infection was found to be 10% in the patients who received single dose antibiotic prophylaxis which was comparable with 9.5% in multiple dose group.

Conclusions: Single-dose antibiotic prophylaxis is as effective as multiple-dose antibiotic prophylaxis in elective caesarean section in preventing post operative infective morbidity.

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References

Cunningham, F Gary. Williams Obstetrics: Cesarean delivery. 25th ed. United States: Tata McGraw Hill; 2018.

Rozenberg P. Evaluation of cesarean rate: a necessary progress in modern obstetrics. J Gynecol Obstet Biol Reprod (Paris). 2004;33(4):279-89.

Van Ham MA, Van Dongen PW, Mulder J. Maternal consequences of caesarean section. A retrospective study of intra-operative and postoperative maternal complications of caesarean section during a 10-year period. Euro J Obstetr Gynecol Reproduct Biol. 1997;74(1):1-6.

Pinto Lopes R, Sousa Pinto B, Azevedo LF. Single dose versus multiple dose of antibiotic prophylaxis in caesarean section: a systematic review and metaanalysis. BJOG: Int J Obstetr Gynaecol. 2017;124(4):595-605.

Sadique I, Abid S, Aleem S, Anwar S, Hafeez M, Pasha MI, Butt F. Single dose prophylaxis in obstetrics and gynaecological surgeries. Ann King Edward Medi Univers. 2009;15(4):176.

Burrows LJ, Meyn LA, Weber AM. Maternal morbidity associated with vaginal versus cesarean delivery. Obstet Gynecol. 2004;104(3):633-4.

Tully L, Gates S, Brocklehurst P, McKenzie-McHarg K, Ayers S. Surgical techniques used during caesarean section operations: results of a national survey of practice in the UK. Eur J Obstet Gynecol Reprod Biol. 2002;102():120-6.

Mohan J, T. Thangaroja, M Menon. Single dose antibiotic prophylaxis in elective obstetrical and gynaecological surgeries-a descriptive study. Int J Reprod Contracept Obstet Gynecol. 2017;6(9):3897-90.

Liu R, Lin L, Wang D. Antimicrobial prophylaxis in caesarean section delivery. Experim Therapeut Medi. 2016;12(2):961-64.

Westen EH, Kolk PR, van Velzen CL, Unkels R, Mmuni NS, Hamisi AD, et al. Single-dose compared with multiple day antibiotic prophylaxis for cesarean section in low-resource settings, a randomized controlled, noninferiority trial. Acta Obstet Gynecol Scand. 2015;94(1):43-9.

Van Schalkwyk J, Van Eyk N, Yudin MH, Boucher M, Cormier B, Gruslin A, et al. Antibiotic prophylaxis in obstetric procedures. J Obstetr Gynaecol Canada. 2010 ;32(9):878-84.

World Health Organization. WHO recommendation on prophylactic antibiotics for women undergoing caesarean section, 2015. Available at: https://www.who.int/publications/i/item/9789240028012. Accessed 01 March 2024.

Muthyala T. Review of recommendations on prophylactic antibiotic use in cesarean section-a review article. J Gynecol Neonatal Biol. 2018;4(1):18-21.

Anuradha K, Majumder P, Shiffin R. Single versus multiple dose of antibiotic prophylaxis in caesarian section: a randomized controlled trial. Obstetr Gynecol Res. 2022;5(3):175-80.

Mishra V. Comparison of single dose versus multiple doses of antibiotic prophylaxis in elective caesarean section. Int J Reprod Contracept Obstet Gynecol. 2022;11(22):3332-9.

Horan TC, Gaynes RP, Martone WJ, Jarvis WR, Emori TG. CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. Infect Control Hosp Epidemiol. 1992;13(10):606-8.

Hebert PR, Reed G, Entman SS, Mitchel EF, Berg C, Griffin MR. Serious maternal morbidity after childbirth: prolonged hospital stays and readmissions. Obstet Gynecol. 1999;94(6):942-7.

Dhar H, Al-Busaidi I, Rathi B, Nimre EA, Sachdeva V, Hamdi I. A study of post-caesarean section wound infections in a regional referral hospital, Oman. Sultan Qaboos Univ Med J. 2014;14(2):211-7.

Sandeep BK, Choudhary D. Efficacy of intravenous single dose of cefazolin versus multiple doses of cefazolin for antibiotic prophylaxis for cesarean section. J Dent Med Sci. 2016;92-7.

Shah Z, Kshirsagar NS, Shah S. Comparison of single dose prophylactic antibiotics versus five days antibiotic in cesarean section. J Evo Med Dent Sci. 2014;3(12):3123-9.

Ansari N, Das CR, Ansari MA. Evaluation of prophylactic antibiotic in caesarean section. J Nepalgunj Med Coll. 2016;12(2):40-1.

Njoku CO, Njoku AN. Microbiological pattern of surgical site infection following caesarean section at the University of Calabar Teaching Hospital. Open Access Maced J Med Sci. 2019;7(9):1430-35.

Devi SL, Durge DVK. Surgical site infections post cesarean section. Int J Reprod Contracept Obstet Gynecol. 2018;7(6):2486-9.

Igwemadu GT, Eleje GU, Eno EE, Akunaeziri UA, Afolabi FA, Alao AI, et al. Single-dose versus multiple-dose antibiotics prophylaxis for preventing caesarean section postpartum infections: A randomized controlled trial. Women's Health. 2022;18:17455057221101071.

Bhattachan K, Baral GN, Gauchan L. Single versus multiple dose regimen of prophylactic antibiotic in cesarean section. Nepal J Obstetr Gynaecol. 2013;8(2):50-3.

Pooja P, Hadi V, Rao S, Mallapur A, Katageri G. Single dose single antibiotic versus multiple doses multiple antibiotic prophylaxis in caesarean section, at a tertiary care centre. N Ind Jo OBGYN. 2021;7(2):123-8.

Shaheen S, Akhtar S. Comparison of single dose versus multiple doses of antibiotic prophylaxis in elective caesarian. J Postgrad Med Inst. 2014;28(1):83-6.

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Published

2024-08-29

How to Cite

Kodanda Rama, B., & Mariyappa, N. S. (2024). Effectiveness of single versus multiple doses of antibiotics in elective cesarean section for prevention of post operative morbidity. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 13(9), 2464–2471. https://doi.org/10.18203/2320-1770.ijrcog20242500

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Original Research Articles