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Prophylactic ampicillin versus cefazolin for the prevention of post‐cesarean infectious morbidity in Rwanda
Author(s) -
Mivumbi Victor N.,
Little Sarah E.,
Rulisa Stephen,
Greenberg James A.
Publication year - 2014
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2013.09.017
Subject(s) - medicine , cefazolin , ampicillin , antibiotics , antibiotic prophylaxis , randomized controlled trial , surgery , prospective cohort study , anesthesia , microbiology and biotechnology , biology
Objective To evaluate the efficacy of ampicillin versus cefazolin as prophylactic antibiotics prior to cesarean delivery in Rwanda. Methods In a prospective, randomized, open‐label, single‐site study conducted between March and May 2012, the effects of prophylactic ampicillin versus cefazolin were compared among women undergoing cesarean delivery at the Centre Hospitalier Universitaire de Kigali, Rwanda. Postoperatively, participants were evaluated daily for infectious morbidity while in the hospital. Follow‐up was done by phone and by appointment at the hospital within 2 weeks of delivery. Results During the study period, there were 578 total deliveries and 234 cesarean deliveries (40.4%). Overall, 132 women were enrolled in the study and randomized to receive either ampicillin (n = 66) or cefazolin (n = 66). No women were lost to follow‐up. The overall infection rate was 15.9% (21/132). The infection rate in the ampicillin group and the cefazolin group was 25.8% (17/66) and 6.1% (4/66), respectively. Conclusion Implementing a universal protocol in Rwanda of prophylactic cefazolin prior to cesarean delivery might reduce postoperative febrile morbidity, use of postoperative antibiotics, and number of postoperative days in hospital.