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Single or triple dose piperacillin prophylaxis in elective cesarean section
Author(s) -
Shah S,
Mazher Y,
John I.S
Publication year - 1998
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/s0020-7292(98)00063-0
Subject(s) - medicine , piperacillin , metronidazole , cephradine , regimen , surgery , antibiotic prophylaxis , randomized controlled trial , perioperative , anesthesia , premedication , antibiotics , cephalosporin , genetics , bacteria , microbiology and biotechnology , pseudomonas aeruginosa , biology
Objective: To evaluate the efficacy and safety of piperacillin in the prevention of perioperative febrile morbidity in elective cesarean sections, a combination of cephradine plus metronidazole vs. a control group which did not receive any antibiotic prophylaxis. Method: 198 women undergoing elective cesarean section were included in a randomized control study to compare the prophylactic efficacy and safety of a single dose (4 g) or three doses (2 g) of piperacillin, three doses of cephradine plus metronidazole combination, when administered peri‐operatively and a control group which did not receive prophylactic antibiotics. Result: 198 women were randomized to the study, but 14 had to be excluded leaving 184 for analysis. Statistically significant difference was reached when comparing the piperacillin groups (group A and group C) with control (group D) in the prevention of postoperative febrile morbidity inclusive of wound infection and endomyometritis (single‐dose piperacillin group A: Relative Risk=0.14, 95% CI 0.03–0.58). Multi‐dose piperacillin therapy group C: R.R.=0.27, 95% CI 0.10–0.77). The combination of cephradine and metronidazole (group B) when compared with the control group did not show any statistical significant difference in prevention of postoperative febrile morbidity (R.R.=0.49, 95% CI 0.22–1.10). Single‐dose piperacillin when compared to multi‐dose piperacillin regimen appears to be more effective at reducing postoperative infective morbidity but this is not statistically significant (R.R.=0.51, 95% CI 0.10–2.65). When febrile morbidity is separated into wound infection and myometritis, the reduction rates in either of them in each antibiotic study group A, B and C compared to the control group D are not significant except when study groups A and C are combined and compared to control group D (R.R.=0.21, 95% CI 0.76–0.06). Conclusion: Piperacillin single agent therapy, either as a single dose of 4 g or a triple dose of 2 g, is effective and safe in the prevention of postoperative infection when given as prophylaxis in elective cesarean cases.