摘要

This prospective, randomized, controlled trial was performed to evaluate the effectiveness of single-dose antibiotic prophylaxis versus common five-day combination antibiotic therapy in decreasing the infectious morbidity, following elective caesarean section.Eighty-six women undergoing elective caesarean section were randomly enrolled in the study in 2 groups, 43 patients each. There was no statistical difference in the admission variables between the two groups. Group I had single-dose cefuroxime (C) 1.5 g intravenously after umbilical cord clamping; group II had common procain-benzilpenicilin (PBP) 1.600.000 IU, and gentamycin (G) 120 mg every 12h, intramuscularly, for 5 days. Postpartum complications, including febrile morbidity, wound infection, endometritis, urinary tract infection, and transient postpartum fever were recorded during hospitalization. Wound infection was the most common complication occurring in 13.95% of women in group I and 18.61 % in group II. Five-day antibiotic therapy did not decrease febrile morbidity, wound infection, endometritis and urinary tract infection. On average, women who received cefuroxime stayed in hospital a day less than those who received PBP/G (7.6 vs. 8.7 days). Four women (9.3%) in group I and five women (11.63%) in group II had microbiological evidence of wound infection. Staphylococcus aureus was the most common pathogen (48%) isolated. The same proportions in both groups (2.3% in group I and 2.3% in group II) required the antibiotic change.Common combined antibiotic prolonged therapy in elective caesarean section did not reduce postoperative infectious morbidity in this study. According to this, it is important to emphasize that five-day combined antibiotic use is absolutely unjustified and irrational prophylaxis modality, since the antibiotic prophylaxis lasts three days at the most. Postoperative infectious morbidity rate is not lower than other acceptable modalities of antibiotic prophylaxis.

全文