Antibiotic prophylaxis for Cesarean delivery: a randomized trial of cefotetan, ampicillin-sulbactam and ciprofloxacin

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.