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Different classes of antibiotics given to women routinely for preventing infection at caesarean section.

Abstract

BACKGROUND

Caesarean section increases the risk of postpartum infection for women and prophylactic antibiotics have been shown to reduce the incidence; however, there are adverse effects. It is important to identify the most effective class of antibiotics to use and those with the least adverse effects.

OBJECTIVES

To determine, from the best available evidence, the balance of benefits and harms between different classes of antibiotic given prophylactically to women undergoing caesarean section.

SEARCH STRATEGY

We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (April 2010) and reference lists of retrieved papers.

SELECTION CRITERIA

We included randomised controlled trials comparing different classes of prophylactic antibiotics given to women undergoing caesarean section. We excluded trials that compared drugs with placebo or drugs within a specific class; these are assessed in other Cochrane Reviews.

DATA COLLECTION AND ANALYSIS

Two review authors independently assessed the studies for inclusion, assessed risk of bias and carried out data extraction.

MAIN RESULTS

We included 29 studies of which 25 provided data on 6367 women. There was a lack of good quality data and important outcomes often included only small numbers of women. This meant we could only conclude that the current evidence shows no overall difference between the different classes of antibiotics in terms of reducing maternal infections after caesarean sections. However, none of the studies looked at outcomes on the baby, nor did they report infections diagnosed after the initial postoperative hospital stay. We were unable to assess what impact, if any, the use of different classes of antibiotics might have on bacterial resistance.

AUTHORS' CONCLUSIONS

Based on the best currently available evidence, cephalosporins and penicillins have similar efficacy at caesarean section when considering immediate postoperative infections. We have no data for outcomes on the baby, nor on late infections (up to 30 days) in the mother. Clinicians need to consider bacterial resistance and women's individual circumstances.

Authors+Show Affiliations

School of Reproductive and Developmental Medicine, Division of Perinatal and Reproductive Medicine, The University of Liverpool, First Floor, Liverpool Women's NHS Foundation Trust, Crown Street, Liverpool, UK, L8 7SS.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

20927776

Citation

Alfirevic, Zarko, et al. "Different Classes of Antibiotics Given to Women Routinely for Preventing Infection at Caesarean Section." The Cochrane Database of Systematic Reviews, 2010, p. CD008726.
Alfirevic Z, Gyte GM, Dou L. Different classes of antibiotics given to women routinely for preventing infection at caesarean section. Cochrane Database Syst Rev. 2010.
Alfirevic, Z., Gyte, G. M., & Dou, L. (2010). Different classes of antibiotics given to women routinely for preventing infection at caesarean section. The Cochrane Database of Systematic Reviews, (10), CD008726. https://doi.org/10.1002/14651858.CD008726
Alfirevic Z, Gyte GM, Dou L. Different Classes of Antibiotics Given to Women Routinely for Preventing Infection at Caesarean Section. Cochrane Database Syst Rev. 2010 Oct 6;(10)CD008726. PubMed PMID: 20927776.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Different classes of antibiotics given to women routinely for preventing infection at caesarean section. AU - Alfirevic,Zarko, AU - Gyte,Gillian Ml, AU - Dou,Lixia, Y1 - 2010/10/06/ PY - 2010/10/8/entrez PY - 2010/10/12/pubmed PY - 2010/12/14/medline SP - CD008726 EP - CD008726 JF - The Cochrane database of systematic reviews JO - Cochrane Database Syst Rev IS - 10 N2 - BACKGROUND: Caesarean section increases the risk of postpartum infection for women and prophylactic antibiotics have been shown to reduce the incidence; however, there are adverse effects. It is important to identify the most effective class of antibiotics to use and those with the least adverse effects. OBJECTIVES: To determine, from the best available evidence, the balance of benefits and harms between different classes of antibiotic given prophylactically to women undergoing caesarean section. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (April 2010) and reference lists of retrieved papers. SELECTION CRITERIA: We included randomised controlled trials comparing different classes of prophylactic antibiotics given to women undergoing caesarean section. We excluded trials that compared drugs with placebo or drugs within a specific class; these are assessed in other Cochrane Reviews. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed the studies for inclusion, assessed risk of bias and carried out data extraction. MAIN RESULTS: We included 29 studies of which 25 provided data on 6367 women. There was a lack of good quality data and important outcomes often included only small numbers of women. This meant we could only conclude that the current evidence shows no overall difference between the different classes of antibiotics in terms of reducing maternal infections after caesarean sections. However, none of the studies looked at outcomes on the baby, nor did they report infections diagnosed after the initial postoperative hospital stay. We were unable to assess what impact, if any, the use of different classes of antibiotics might have on bacterial resistance. AUTHORS' CONCLUSIONS: Based on the best currently available evidence, cephalosporins and penicillins have similar efficacy at caesarean section when considering immediate postoperative infections. We have no data for outcomes on the baby, nor on late infections (up to 30 days) in the mother. Clinicians need to consider bacterial resistance and women's individual circumstances. SN - 1469-493X UR - https://www.unboundmedicine.com/medline/citation/20927776/Different_classes_of_antibiotics_given_to_women_routinely_for_preventing_infection_at_caesarean_section_ L2 - https://doi.org/10.1002/14651858.CD008726 DB - PRIME DP - Unbound Medicine ER -