Show Summary Details
Page of

Prophylactic antibiotics with cesarean section 

Prophylactic antibiotics with cesarean section
Prophylactic antibiotics with cesarean section

Murray Enkin

, Marc J. N. C. Keirse

, James Neilson

, Caroline Crowther

, Lelia Duley

, Ellen Hodnett

, and Justus Hofmeyr

Page of

PRINTED FROM OXFORD MEDICINE ONLINE ( © Oxford University Press, 2021. All Rights Reserved. Under the terms of the licence agreement, an individual user may print out a PDF of a single chapter of a title in Oxford Medicine Online for personal use (for details see Privacy Policy and Legal Notice).

date: 19 September 2021

Antibiotic prophylaxis can reduce the risk of serious infections. If the level of post-cesarean infectious morbidity is very low without a policy of antibiotic prophylaxis, the ratio of benefits to costs, in absolute terms, might argue against instituting such a policy. Such circumstances are rare, and the evidence justifies far wider adoption of antibiotic prophylaxis than currently exists. Although the incidence of adverse drug effects among women receiving prophylactic antibiotics has probably been underestimated, it is inconceivable that it could outweigh the reduction in serious maternal morbidity that can be achieved by a policy of antibiotic prophylaxis. Potential adverse drug effects in the baby may be lessened by beginning prophylaxis after the umbilical cord has been divided. The risk of adverse ecological effects is likely to be reduced if the total load of antibiotics is reduced. The disadvantages of longer courses of antibiotics, in terms of an increase in the total antibiotic load and in the number of women experiencing side effects, and the additional financial cost, may outweigh the advantages of greater prophylactic efficacy compared with shorter or single-dose regimens. In regard to choice of antibiotic, the broad-spectrum penicillins are as effective as the cephalosporins. No strong case for using a secondor third-generation cephalosporin, or adding aminoglycosides to broad-spectrum penicillins, can be made.

Withholding prophylactic antibiotics from women having cesarean section will increase the chances that they will experience serious morbidity. Further trials which include no-treatment controls would be unethical.

Access to the complete content on Oxford Medicine Online requires a subscription or purchase. Public users are able to search the site and view the abstracts for each book and chapter without a subscription.

Please subscribe or login to access full text content.

If you have purchased a print title that contains an access token, please see the token for information about how to register your code.

For questions on access or troubleshooting, please check our FAQs, and if you can't find the answer there, please contact us.