Ijarotimi A O, Badejoko O O, Ijarotimi O, Loto O M, Orji E O, Fasubaa O B
Department of Obstetrics, Gynaecology and Perinatology, Obafemi Awolowo University, Ile-Ife.
Niger Postgrad Med J. 2013 Dec;20(4):325-30.
This study was to determine any significant difference between the incidence of infectious morbidity with the use of a 24 hour antibiotics regimen compared to a 7-day course of antibiotics following elective caesarean section using a cheap and easily available combination of Ampicillin/Cloxacillin and Metronidazole.
Two hundred patients planned to have elective caesarean section for various indications and who satisfied the inclusion criteria were enrolled in the study in two groups of 100 patients each between the period of January to June 2010. Patients were randomized to receive either Ampiclox as 4 intravenous doses of 1g stat and 500 mg each 6 hourly and Metronidazole as 3 intravenous doses of 500 mg each 8 hourly both for 24 hours or same combination intravenously for 48 hours and subsequent oral use for 5 days.
The mean maternal age, parity, gestational age and indication for caesarean section were similar in the two groups of participants. There was no statistical difference in the incidence of febrile morbidity (17%/18%, p=0.852), urinary tract infection (6%/4%, p=0.196), wound infection (4%/3%, p=0.056) and endometritis (3%/2%, p=0.367). The mean cost of antibiotics per patient (N730/$4.65) in the short term prophylaxis group was half that of the long term prophylaxis group (N1, 540/$9.81).
There was no difference in the incidence of infection related morbidity when short term prophylactic antibiotics was used at elective caesarean section compared to long term prophylactic antibiotics.
本研究旨在确定在择期剖宫产术后使用24小时抗生素方案与使用7天抗生素疗程相比，使用廉价且易于获得的氨苄西林/氯唑西林和甲硝唑组合时，感染性发病率是否存在显著差异。
2010年1月至6月期间，将200名因各种适应症计划进行择期剖宫产且符合纳入标准的患者分为两组，每组100名。患者被随机分配接受以下治疗：氨苄西林/氯唑西林，静脉注射4剂，首剂1g，随后每6小时500mg；甲硝唑，静脉注射3剂，每8小时500mg，均持续24小时；或者相同组合静脉注射48小时，随后口服5天。
两组参与者的平均产妇年龄、产次、孕周和剖宫产指征相似。发热性发病率（17%/18%，p = 0.852）、尿路感染（6%/4%，p = 0.196）、伤口感染（4%/3%，p = 0.056）和子宫内膜炎（3%/2%，p = 0.367）的发生率无统计学差异。短期预防组每位患者的抗生素平均费用（730奈拉/4.65美元）是长期预防组（1540奈拉/9.81美元）的一半。
择期剖宫产时使用短期预防性抗生素与长期预防性抗生素相比，感染相关发病率无差异。
