Comparison of single dose of cefazolion versus single dose of cefazolin plus seven days cephalexin prophylactic therapy in postoperative infections after elective cesarean section and immediate adverse effect of antibiotic on infants

Cesarean section is a surgery which has an important role in decreasing maternal and fetal morbidity in some special deliveries. But, it should be noted that infection due to caesarean section is one of the major cause of maternal morbidity and antibiotics are effective in prophylaxis of infection. This study was performed with aim to determine the necessary duration of antibiotic therapy to reduce infections in cesarean section.
This randomized clinical trial, case-control study was performed on 204 women who were candidate for non-emergency cesarean section in Shohadaye Khalije Fars, Bushehr from 2014 to 2015. They were randomly divided to intervention (received single dose of prophylactic antibiotic after clamping umbilical cord) and control (received single dose of prophylactic antibiotic plus seven days of antibiotic after surgery) groups. They were assessed during 48 h after hospitalization in terms of fever, chills, cellulitis, discharge from incision site, uterine tenderness and they were also followed one week after discharge by referring to the clinic or hospital. Their infants were also evaluated during mother's hospitalization and also when referring by mother in terms of neonatal outcomes such as diarrhea, rash, and oral candidiasis. Data analysis was performed by SPSS software (version 18) and independent t-test, Chi-square and Fisher's exact test.
There was no significant difference between the intervention and control groups in term of maternal complications including urinary tract infection by urine analysis (P=0.118), urine culture (P=0.180), metritis (P=0.622) and surgical site infection (P=0.076). Neonatal complications including diarrhea (P=0.621), rash (P=1).and oral candidiasis (P=1) has no significant difference between intervention and control groups.
Single dose antibiotic can be used instead of seven day regimen of antibiotics to reduce the infection in non-emergency cesarean sections.