Antibiotic prophylaxis of infective complications after cesarean section. Our experience.

BACKGROUND: The efficacy of a single dose of antibiotic vs multiple doses of the same drug, in reducing maternal infections following the cesarean section, is evaluated. METHODS: A total of 206 pregnant women undergoing elective or emergency cesarean section from 1st June 1998 to 30 June 1999, at the Department of Obstetrics and Gynecology of the University of L'Aquila, were included in a randomized study to compare the efficacy of prophylaxis with a single dose of piperacillin sodium (2 g i.v. after the umbilical cord clamping; group A) vs triple doses of the same antibiotic (2 g i.v. at 6 hourly intervals, beginning from the umbilical cord clamping; group B). RESULTS: The incidence of infective morbidity in group A was 7.3%, with a 2% wound infections, 1% urinary infections and 4.16% febrile morbidity. The incidence of infective morbidity in group B was not much higher (9%), with 2.7% wound infections, 1.8% urinary infections and 4.5% febrile morbidity. CONCLUSIONS: In order to obtain a useful antibiotic prophylaxis in cesarean sections, the single-dose seems to be preferable to the multiple-doses, since the single-dose not only has equal efficacy, but also less cost, smaller risk of super-infections by resistant organisms and it involves smaller care from the-medical and nursing staff.