Article type
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Abstract
Background: The timing of prophylactic antibiotics for cesarean delivery is controversial all the time. Prophylactic antibiotics was still given at the time of clamping umbilical cord in China.
Objective: To summarize the recent studies’ results of the timing of perioperative antibiotics at cesarean delivery and make high quality evidence.
Method: Computerized searched the study published in MEDLINE (2008.1–2012.2), EMBase (2008.1–2012.2) and Cochrane Central Register of Controlled Trials (Issue 2 of 12, February 2012). Only randomized controlled trails that compared prophylactic antibiotic that were given preoperatively or after clamping the umbilical cord were included.
Result: Seven randomized controlled trails were included, which contained 1354 women receiving prophylactic antibiotics before skin incision and 1246 women after clamping the umbilical cord. The meta-analysis shows that preoperative prophylactic antibiotics can reduce the risk of postpartum endometritis (RR = 0.57, 95% CI 0.36, 0.90), wound infection (RR = 0.67, 95% CI 0.42, 1.07), and total infectious morbidity (RR = 0.70, 95% CI 0.53, 0.93), which has no significant influence on the risk of neonatal sepsis (RR = 0.86, 95% CI 0.51, 1.47), sepsis workups (RR = 0.93, 95% CI 0.72, 1.21), or neonatal intensive care unit admissions (RR = 0.69, 95% CI 0.94, 1.34) between two groups. The result of four high quality studies among the seven shows similarly.
Conclusion: The prophylactic antibiotics which used 0.5–1 hour preoperatively for cesarean delivery can decrease the postpartum endometritis, wound infection and total infectious morbidity without a bad short-term effect on neonates. So the use of antibiotics 0.5–1 hour preoperatively for cesarean delivery is recommended.
Objective: To summarize the recent studies’ results of the timing of perioperative antibiotics at cesarean delivery and make high quality evidence.
Method: Computerized searched the study published in MEDLINE (2008.1–2012.2), EMBase (2008.1–2012.2) and Cochrane Central Register of Controlled Trials (Issue 2 of 12, February 2012). Only randomized controlled trails that compared prophylactic antibiotic that were given preoperatively or after clamping the umbilical cord were included.
Result: Seven randomized controlled trails were included, which contained 1354 women receiving prophylactic antibiotics before skin incision and 1246 women after clamping the umbilical cord. The meta-analysis shows that preoperative prophylactic antibiotics can reduce the risk of postpartum endometritis (RR = 0.57, 95% CI 0.36, 0.90), wound infection (RR = 0.67, 95% CI 0.42, 1.07), and total infectious morbidity (RR = 0.70, 95% CI 0.53, 0.93), which has no significant influence on the risk of neonatal sepsis (RR = 0.86, 95% CI 0.51, 1.47), sepsis workups (RR = 0.93, 95% CI 0.72, 1.21), or neonatal intensive care unit admissions (RR = 0.69, 95% CI 0.94, 1.34) between two groups. The result of four high quality studies among the seven shows similarly.
Conclusion: The prophylactic antibiotics which used 0.5–1 hour preoperatively for cesarean delivery can decrease the postpartum endometritis, wound infection and total infectious morbidity without a bad short-term effect on neonates. So the use of antibiotics 0.5–1 hour preoperatively for cesarean delivery is recommended.