PMID: 2485712Dec 1, 1989Paper

Infection following caesarean section: a study of the literature and cases with emphasis on prevention

The Central African Journal of Medicine
C King

Abstract

Many factors influence the incidence of sepsis following caesarean section. In Zimbabwe all caesars probably warrant prophylactic antibiotics. These should be given parenterally in high doses, starting peri-operatively. Single doses have been found effective. An overall 26 percent incidence of infection was found in 46 consecutive caesars at Hwange. Ruptured membranes for 6 hours or more, duration of operation 60 minutes or more, and post-operative haemoglobin less than 9.5 g percent were significantly associated with infection. A prolonged post-operative course of benzylpenicillin plus streptomycin appeared to have no advantage over three perioperative doses of chloramphenicol. The results support the contention that antibiotic prophylaxis for caesarean section should be perioperative, ensuring a high plasma concentration of antibiotic during the operation. Further study is needed to determine the best drug of combination and the optimum number of doses. Prophylaxis needed may vary with the degree of risk, but at present this cannot be reliably assessed.

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