The routine use of cefazolin in cesarean section

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Abstract
Objective: To determine the effectiveness and safety of the routine use of antibiotic prophylaxis in women undergoing cesarean section. Method: Four hundred and forty‐one women undergoing cesarean sections were randomly assigned either to a single dose of 1 g intravenous cefazolin or placebo after clamping of the umbilical cord. The primary outcome was the development of post‐operative febrile morbidity and the secondary outcomes were infection‐related complications. Result: There were 211 emergency and 230 elective cesarean sections. In the emergency cesarean sections, 34 (30.6%) women developed post‐operative febrile morbidity in the placebo group compared to 11 (11%) women in the cefazolin group. This was a statistically significant difference (P=0.001). Similarly, there were statistically significant differences between the two groups in the development of wound infection (PP=0.001), and post‐operative days in hospital (P=0.003). No statistically significant differences were detected in the development of other infection‐related complications. In the elective cesarean sections, no statistically significant differences were found in post‐operative febrile morbidity and infection‐related complications. There were no serious side effects related to the use of cefazolin. Conclusion: The routine use of a single dose of cefazolin is safe and effective in emergency but not elective cesarean section.

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