Role of Pre-Cesarean Section Amoxicillin and Ceftriaxone in Ameliorating Post-Cesarean Infection: A Randomized Control Trial

Role of Pre-Cesarean Section Amoxicillin and Ceftriaxone in Ameliorating Post-Cesarean Infection

Abstract

Abstract

Objective: Caesarean sections (CS) and surgical vaginal births are established risk factors for maternal infection. Caesarean surgical site infections (SSIs) are the most common infections found in a majority of cases and can be avoided by using the appropriate antibiotic prophylaxis. Prophylaxis can be used in pre/intra/post-operative period. Despite available guidelines on preoperative antibiotic prophylaxis, there are discrepancies in antibiotic selection in clinical practice based on obstetricians' preferences. There is insufficient evidence available to support the use of selective prophylaxis and current WHO recommendations do not suggest routine antibiotic prophylaxis for women having surgical vaginal births. The current study aimed to evaluate the efficacy of two broad-spectrum antibiotics for maternal infection after CS.

Method: The prospective study was conducted with 482 subjects (aged ≥ 16 years) from single centered tertiary care hospital, in Lahore. Women were randomly allocated into two groups; each group contain 241 participants; Group 1: was given amoxicillin before and after CS; Group 2: was given ceftriaxone before and after CS. The primary outcome of the treatment was the presence/absence of maternal infection.

Results: In the amoxicillin-received group (n=241), only 4 (1.7%) female get wound infections compared to 6 (2.5%) women of the ceftriaxone-treated group (n=241) (OR=0.751, 95% CI=0.209-2.695, p-value=0.659).

Conclusion: In low-resource settings, a simple dosage of prophylactic amoxicillin and ceftriaxone have the same efficacy and effectiveness for preventing post-caesarean wound infections therefore both can be considered an effective prophylactic to reduce the risk of post-caesarean wound infection in the local population.