An international survey of practice variation in the use of antibiotic prophylaxis in cesarean section

Objective: To examine the use of antibiotic prophylaxis in cesarean section in different countries and in relation to a reference regimen. Method: Fif ty consecutive cesarean sections performed in eight centers in five countri es were surveyed. Data from each center were compared to a regimen recommen ded by the Cochrane Collaboration tone dose of ampicillin or cefazolin admi nistered to all women shortly before the procedure or immediately after cor d clamping) using logistic regression with adjustment for procedure type. R esult: Prophylaxis was used widely, but only four centers administered prop hylaxis to all women. Ampicillin and cefazolin were the principal antibioti cs used, but broad-spectrum agents and multidrug regimens were also used co mmonly. Only two centers reliably administered the antibiotic at the approp riate time. The majority of women received only one dose of antibiotic in o nly three centers. Conclusion: The use of antibiotic prophylaxis in cesarea n section was variable and often at odds with published recommendations. (C ) 2001 International Federation of Obstetrics and Gynecology. All rights re served.