Incidence of Postpartum Endomyometritis FollowingSingle-Dose Antibiotic Prophylaxis With EitherAmpicillin/Sulbactam, Cefazolin, or Cefotetan inHigh-Risk Cesarean Section Patients

[摘要] Objective:To assess the efficacy of Single-dose antibiotic prophylaxis against postpartum endomyometritisin high-risk cesarean section patients.Design:Patients were administered one of three single-dose antibiotic regimens following umbilicalcord clamping after cesarean section delivery.Setting:Prospective randomized trial at a university-based hospital.Patients:The study evaluated 293 consenting women undergoing cesarean section who hadeither experienced labor for a duration of ≥ 6 hr or rupture of amniotic membranes.Main outcome measures:Development of postpartum endomyometritis.Results:The incidence of postpartum endomyometritis was 7/95 (7.4%) following the ampicillin/sulbactam regimen, 14/98 (14.3%) after the cefazolin regimen, and 11/99 (11.1%) after the cefotetanregimen. There was no significant difference in postpartum infection among the three study arms.In addition, the incidence of endomyometritis in the three single-dose study arms was not higherthan previously noted in studies where three doses of antibiotic were administered.Conclusion:Single-dose antibiotic prophylaxis should replace the standard triple-dose therapy foruninfected women undergoing cesarean section who are at risk for postoperative endomyometritis.Ampicillin/sulbactam, cefazolin, and cefotetan are all reasonable antibiotic choices for single-dosetherapy.

[学科分类] 妇产科学