Title: Comparative Evaluation of Antibiotic Prophylaxis in Caesarean Section before Skin Incision and after Cord Clamping
Authors: Chanda Rai, Sunita Malik, Harish Chellani, Jagdev Kaur, Harsha Gaikwad
DOI: https://dx.doi.org/10.18535/jmscr/v6i6.167
Abstract
Introduction
Caesarean section has been invariably associated with the use of antibiotics in post-operative period of a patient. It has been seen that caesarean delivery causes five to twentyfold increase in infection rates as compared with vaginal delivery. [1] Infection remains one of the top five causes of pregnancy related mortality and contributes to maternal morbidity.[2] With the upsurge of caesarean rates world-wide, chances of post- operative infections have increased, and here comes the role of antibiotics to help prevent and combat the infections. However, in recent times the injudicious and prolonged administration of antibiotics have led to a surge in the emergence of resistant strains of micro-organisms. With no newer antibiotic coming up for the the next few years, optimum use of antibiotics remains a challenge for us. In our study single prophylactic dose of antibiotic was given pre-operatively to prevent development of surgical site infections in postoperative period. Our dilemma was whether to administer it before skin incision or delaying it till cord clamping to prevent neonatal transfer of antibiotics which is supposed to mask neonatal infections and their microbial cultures which in turn interferes with proper treatment. According to recent data by Russel antibiotics reaching the baby due to trans- placental transfer can alter their gut flora and affect their developing immune system.[3] So this study aims to find out the correct timing of administration of antibiotic and whether a single pre-operative dose of antibiotic is sufficient to prevent SSIs in caesarean deliveries.
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