Jd. Busowski et al., Antibiotic prophylaxis for Cesarean delivery: a randomized trial of cefotetan, ampicillin-sulbactam and ciprofloxacin, PRENAT N M, 5(6), 2000, pp. 357-362
Objective Our purpose was to compare the efficacy and safety of three antib
iotics for Cesarean section prophylaxis.
Methods Patients in labor for more than 2 h without evidence of infection w
ere eligible for enrolment in this randomized clinical trial. A total of 11
4 patients were prospectively randomized to receive 1 g cefotetan, 1.5 g am
picillin-sulbactam or 200 mg ciprofloxacin immediately after umbilical cord
clamping. Patients were evaluated for postoperative morbidity including fe
ver, endometritis, wound infection, urinary tract infection and duration of
postoperative hospital stay.
Results No significant differences were found among the patient groups with
respect to the frequency of fever, endometritis or wound infection, or dur
ation of postoperative hospitalization. A higher frequency of urinary tract
infections occurred in patients who received ampicillin-sulbactam (p < 0.0
4).
Conclusion Although all three antibiotics were equally effective in prevent
ing endometritis and wound infections, the high incidence of symptomatic ur
inary tract infections in patients treated with ampicillin-sulbactam makes
it difficult to recommend ampicillin-sulbactam for infection prophylaxis at
Cesarean delivery.