Aisha Wah, Zubaida Taj, Zeba Abbas.
Chemoprophylaxis in Caesarean Sections.
J Coll Physicians Surg Pak Jan ;12(2):78-81.

Objective: To assess whether antimicrobial therapy can be reduced without compromising quality of life in cases of cesarean section. Design: A prospective case-controlled study. Place and Duration of Study: Study was conducted at Aga Khan Hospital for Women and Children, Kharadar, Karachi from February to August, 2000. Subjects and Methods: All cases of caesarean-section were included except those with high risk factors or sign and symptom of infection like absent membranes for more than twenty-four hours or fever at admission. A total of 220 patients were grouped into control group I having 122 patients (with five days i/v antimicrobials), control group II (with 24-28 hours i/v antimicrobials postoperative followed by oral for 5 days ) and rest of 55 patients were taken in study group i/v prophylactic antimicrobials - 3 dose regime. Results: In study group there was no wound gaping compared to control group I that had 3.3% (p >0.05=NS) and control group II that had 2.3% (p >0.05=NS). There was 1.8 % wound discharge in study group as compared to control group I (4.9%) and control group II (4.6%). The cost of prophylaxis ranged from Rs. 555 to Rs. 2550. Conclusion: Three dose regime of antimicrobials proved to be superior (safe, very economical and effective) in prevention of infection in cases of C-section when compared to prolonged oral and systemic use of antimicrobials in this study. However, since the results were not statistically significant further studies with .larger number of patients is recommended.

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