Timing of prophylactic antibiotics during cesarean: a meta-analysis up to 2012

Download poster as PDF

Download poster as PDF

Abstract text
Backgroud: 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, Feb 2012).Only randomized controlled trails that compared prophylactic antibiotic that were given preoperatively or after clamping the umbilical cord were included.
Result: 7 randomized controlled trails were included, which contained 1354 women received 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 neonatal 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 4 high quality study among the seven shows similarly.
Conclusion: The prophylactic antibiotics which used 0.5-1h 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 0.5-1h preoperatively for cesarean delivery is recommended.
Authors
Zhang C1, Zhang LL1, Chen MH1, Zhang L2
1 Pharmacy of west China second university hospital, Sichuan University,China
2 Obstetrics of west China second university hospital, Sichuan University,China
Presenting author and contact person
Presenting author: 
Chuan Zhang
Contact person Affiliation Country
Chuan Zhang (Contact this person) West China Second University hospital, Sichuan University China