To study the effectiveness of prophylactic use of ceftriaxone (single dose) in caesarean section in low risk patients in a tertiary care center, Moradabad, India

Ruby Kumari, Arti Sharma, . Sheetal, Pratibha Roy, . Anupriya


Background: There is increasing incidence of caesarean section throughout the world. As caesarean section is associated with infectious complications which increase the rate of morbidity and mortality of mothers. For prevention of infectious complications antibiotics are used but careless use of antibiotics increasing incidence of antibiotic resistance. Many guidelines and studies recommend single dose antibiotic prophylaxis for women undergoing elective or non-elective caesarean section. The aim of this study was to assess the effectiveness of Ceftriaxone as prophylactic antibiotic (single dose) in caesarean section in low risk patients.

Methods: A Prospective single blind study was carried out in the department of obstetrics and gynaecology, TMMC and RC Moradabad, a tertiary care center, in all low risk patients underwent for Elective and Emergency Lower segment caesarean section for 1 year from 1st June 2015 to May 2016 on 110 patients. Data was collected and analyzed by percentage and proportion.

Results: Prevalence of caesarean section was maximum in women of 26-35years age group (52.72%),about 67.27% was emergency LSCS, most common indication of caesarean section was Fetal distress (29.09%),refusal for vaginal delivery after caesarean section (10.90%) was one of the cause for increasing rate of repeat caesarean section, 41.81% women in labour,72.27% cases were with intact membrane, in 9.09% cases, antibiotic had to change in post-operative period due to urinary tract infection and surgical site infection, most common post-operative complication was superficial surgical site infection with purulent discharge (2.72%). No major life-threatening complication occurred.

Conclusions: Single dose of Ceftriaxone is effective for prevention of post-caesarean infectious complication.


Caesarean section, Endometritis, Infectious complications, Preventive antibiotic, Surgical site infection, Urinary tract infection

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Hofmeyr GJ, Smaill FM. Antibiotic prophylaxis for cesarean section. Cochrane Database of systematic reviews. 2002;3.

Dancer SJ. How antibiotics can make us sick: the less obvious adverse effects of antimicrobial chemotherapy. Lancet Infect Dis. 2004;4:611-9.

Gunn B, Ali S, Abdo-Rabbo A, Suleiman B. An investigation into perioperative antibiotic use during lower segment caesarean sections (LSCS) in four hospitals in Oman. Oman medic J. 2009;24(3):179.

American Society of Health-System Pharmacists. ASHP therapeutic guidelines on antimicrobial prophylaxis in surgery. American Society of Health-System Pharmacists. Am J Heal-Sys Pharm. 1999;56(18):1839-88.

Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol. 1999;20:250-78.

Centers for Medicare and Medicaid Services. Physician Quality Reporting Initiative Specifications Document. Baltimore MD: Author. 2008. 2007:1-341.

Hopkins L, Smaill F. Antibiotic prophylaxis regimens and drugs for cesarean section. Cochrane Database Syst Rev. 1999;2.

Cecatti JG. Antibiotic prophylaxis for caesarean section: RHL commentary (last revised: 18 January 2005). The WHO Reproductive Health Library.

American College of Obstetricians and Gynecologists. ACOG practice bulletin number 47, October 2003: Prophylactic Antibiotics in Labour and Delivery. Ob Gynecol. 2003;102(4):875-82.

Van Schalkwyk J, Van Eyk N, Yudin MH, Boucher M, Cormier B, Gruslin A, ET AL. Antibiotic prophylaxis in obstetric procedures. J Obstetrics Gynaecol Canada. 2010;32(9):878-84.

O'Leary JA, Mullins Jr JH, Andrinopoulos GC. Ampicillin vs. ampicillin-gentamicin prophylaxis in high-risk primary cesarean section. J Repro Medic. 1986;31(1):27-30.

Pitt C, Sanchez-Ramos L, Kaunitz AM. Adjunctive intravaginal metronidazole for the prevention of postcesarean endometritis: a randomized controlled trial. Ob Gynecol. 2001;98(5Pt1):745-50.

Meyer NL, Hosier KV, Scott K, Lipscomb GH. Cefazolin versus cefazolin plus metronidazole for antibiotic prophylaxis at cesarean section. South Med J. 2003;96(10):992-5.

Andrews WW, Hauth JC, Cliver SP, Savage K, Goldenberg RL. Randomized clinical trial of extended spectrum antibiotic prophylaxis with coverage for Ureaplasma urealyticum to reduce post-cesarean delivery endometritis. Obstet Gynecol. 2003;101(6):1183-9.

Tita AT, Hauth JC, Grimes A, Owen J, Stamm AM, Andrews WW. Decreasing incidence of post-cesarean endometritis with extended-spectrum antibiotic prophylaxis. Obstet Gynecol. 2008;111(1):51-6.

Shetty J, Rajshekhar S, Kamath A. Short term antibiotic prophylaxis for emergency cesarean delivery: Is there a difference?. Inter J Gynecol and Obs. 2008;11(1):1-7.

Bagratee JS, Moodley J, Kleinschmidt I, Zawilski W. A randomised controlled trial of antibiotic prophylaxis in elective caesarean delivery. BJOG: Inter J Obstet & Gynaecol. 2001;108(2):143-8.

Sadique I, Abid S, Aleem S, Anwar S, Hafeez M, Pasha MI, Butt F. Single dose prophylaxis in obstetrics and gynaecological surgeries. Annals of King Edward Medical University. 2009;15(4):176.

Mudholkar AS, Taralekar VS, Panchanadikar TM. Study of Prophylactic Single Dose Antibiotic in Obstetrics and Gynecological Procedures in Low Risk Patients. Ind J App Res. 2013;3(3).

Ansari N, Das CR, Ansari MA. Evaluation of Prophylactic Antibiotic in Caesarean Section. J Nepal Medic Coll. 2016;12(2):40-1.

Jyothi S, Vyas NM, Kumar P, Kamath A. Antibiotic prophylaxis for hysterectomy and cesarean section: Amoxicillin-clavulanic acid versus cefazolin. J Obstet and Gynecol Ind. 2010;60(5):419-23.

Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR, Hospital Infection Control Practices Advisory Committee. Guideline for prevention of surgical site infection, 1999. Ame J In Cont. 1999;27(2):97-134.