SINGLE-DOSE VERSUS 3-DOSE CEFOTAXIME PROPHYLAXIS FOR CESAREAN-SECTION

  • 1 January 1985
    • journal article
    • research article
    • Vol. 65  (2) , 189-193
Abstract
A protective randomized study was undertaken in 100 patients undergoing cesarean section to evaluate the efficacy of cefotaxime when given as a single-dose vs. the more traditional triple-dose regimen for prophylaxis. Analysis of the results demonstrated no significant differences in febrile morbidity (14 vs. 20%) or postoperative endometritis (10 vs. 14%) between the single- and triple-dose groups, respectively. Pretherapy aerobic and anaerobic placental cultures were positive in 60% of the overall study population. In those patients who subsequently developed endometritis, 7 (58%) had a positive placental culture, suggesting that this technique is relatively nonspecific as a screening procedure. Results of transcervical culture in the endometritis patients most often demonstrated a polymicrobial picture. Several of the organisms cultured were found to be resistant to cefotaxime, supporting the need to better guide antimicrobial therapy by routine endometrial culturing in patients who fail prophylaxis. Apparently, single-dose administration of cefotaxime is equally effective as triple-dose therapy in reducing postcesarean section endometritis.