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The Efficacy of Antibiotic Prophylaxis in the Prevention of Post-Cesarean Section Endometritis

Published online by Cambridge University Press:  02 January 2015

Leigh Grossman Donowitz  and
Sandra M. Norris
Leigh Grossman Donowitz*
Affiliation:
Departments of Pediatrics and Epidemiology, and the Department of Internal Medicine, University of Virginia School of Medicine, Charlottesville, Virginia
Sandra M. Norris
Affiliation:
Departments of Pediatrics and Epidemiology, and the Department of Internal Medicine, University of Virginia School of Medicine, Charlottesville, Virginia
*
Department of Pediatrics, Box 386, University of Virginia, School of Medicine, Charlottesville, VA 22908
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Abstract

Endometritis is an infectious complication in 9% to 65% of patients delivered by cesarean section. The risk of developing endometritis is greater in the high-risk emergent patient as compared to routine repeat abdominal deliveries. This study describes the incidence of endometritis following cesarean section delivery in different patient groups at the University of Virginia Hospital during a 1-year period and reviews the literature on the efficacy and risks of prophylactic antibiotics in this setting. Of patients not receiving antibiotic prophylaxis, 11 (<1%) of 1,461 normal spontaneous vaginal delivery patients, 7 (16.7%) of 42 repeat and 39 (29.8%) of 131 emergent cesarean section patients developed endometritis. This contrasts to none of the 24 emergent patients who received antibiotic prophylaxis. The literature review shows multiple prospective well-designed and executed studies that demonstrate reliable decreases in the incidence of endometritis with short course antibiotic prophylaxis. Our conclusion is that short course antibiotic prophylaxis is a safe, reproducible, cost-effective and indicated method of reducing the incidence of this costly and serious postoperative infection.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 6 , Issue 5 , May 1985 , pp. 189 - 193
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1985

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