Prevention of postcesarean infectious morbidity with a single dose of intravenous metronidazole.

The efficacy of intravenous metronidazole for the prevention of postcesarean section infectious morbidity was studied in 100 healthy women, randomly given either the drug or a placebo. The metronidazole group received 1.0 g intravenously, immediately after cord clamping. Among the 50 patients who received metronidazole, endometritis developed in 7 (14%) as it did in 15 (30%) of the placebo group (P less than 0.01); wound infection was found in 1 (2%) and 4 (8%), respectively (P less than 0.01). If both infectious complications are compared together, the difference (16% versus 38%) is more significant (P less than 0.001). Metronidazole was well tolerated by the mother and with this type of administration regimen, the fetus is not exposed to the drug. It is concluded that metronidazole, used as here reported, is effective in reducing the frequency of postcesarean section endometritis and wound infection with the consequent clinical and economic impacts.