Prophylactic use of antibiotics for nonlaboring patients undergoing cesarean delivery with intact membranes: A meta-analysis

OBJECTIVE: We performed a meta-analysis to examine the role of antibiotic p rophylaxis in preventing postoperative infections among nonlaboring women u ndergoing cesarean delivery with intact membranes. STUDY DESIGN: A computerized literature search was performed with MEDLINE. Studies were included if they contained data on patients undergoing cesarea n delivery in the absence of labor and ruptured membranes. Only randomized trials with a placebo control group were included. RESULTS: Seven studies were found. Use of antibiotics decreased the risk of all infectious outcomes reported. When the results of 4 studies were poole d, prophylactic antibiotic use was associated with a significant reduction in postoperative fever (relative risk, 0.25; 95% confidence interval, 0.14- 0.44). A similar reduction was noted for endometritis in 4 studies (relativ e risk, 0.05; 95% confidence interval, 0.01-0.38). Two studies reported on wound infection and showed a trend toward a protective effect (relative ris k, 0.59; 95% confidence interval, 0.24-1.45). CONCLUSION: The prophylactic use of antibiotics reduces the risk of postope rative infectious complications after cesarean delivery even in the populat ion at lowest risk.