Utilization of antibiotics for prevention of symptomatic postpartum infections.

This analysis determined the incidence, indications, and efficiency of postpartum antibiotic therapy. At Wilford Hall USAF Medical Center, 384 of 2000 consecutive delivered patients (19.2%) were treated with antibiotics during the postpartum period. The greatest utilization of antibiotics was prophylactic or for subclinical infection (290 patients; 75.5%) as compared to treatment for symptomatic infection. The most frequent indications for therapy were for patients at high risk to develop pelvic infection or to prevent urinary tract infection. The failure of antibiotic therapy and the development of infections other than those for which therapy was given were evaluated. Of the 290 patients treated prophylactically or for subclinical infection, only 11 patients (3.8%) did have subsequent infection necessitating a change in antibiotic therapy. Careful selection of antibiotic therapy in the obstetric patient is essential for effective control of puerperal infections.