To Study the Maternal and Neonatal Outcomes with Prophylactic and Regular Antibiotic Usage in C-Section

SUMMARY: 1) 216 cases of elective caesarean were included in this study. These 216 patients were randomized into two groups,based on the seniority in admission. First admitted 108 patients were allocated to prophylactic group and next 108 to regular regimen group. ❖ In group 1-prophylactic group : 2 dose regimen was administered. Inj. Ceftriaxone 1 gm I.V. within one hour before commencement of surgery, and Another dose is given 6 hours after the 1st dose in same patient. ❖ In group 2, Regular course of antibiotic regimen was administered. inj. Ceftriaxone 1 gm I.V. twice a day for 3 days. ❖ Incidence of febrile morbidity in prophylactic antibiotic group was and in 0.5% and 0%. in regular antibiotic group. This is statistically insignificant. ❖ Incidence of wound induration in prophylactic antibiotic group was 0.5% and 0% in regular antibiotic group. This is statistically insignificant. ❖ Incidence of respiratory tract infection is 0.5% in prophylactic group and none in regular antibiotic group. ❖ No cases of neonatal sepsis was seen in both groups. ❖ Prophylactic antibiotic regime is equally efficacious as Regular course of antibiotics. There was no significant difference noted between the two groups. ❖ The Prophylactic antibiotic regimen is cost effective than the Regular antibiotic usage and the number and duration of antibiotic used is both is very less. ❖ The Prophylactic antibiotic is safe, effective, convenient and saves manpower. Thus preventing irregularity in administering drugs and thus can be used instead of the usual 3 days of iv antibiotic followed by a oral antibiotics regimen that is routinely used in a tertiary care centre. CONCLUSION: From this study it is inferred that the maternal infections-like febrile morbidity, wound induration, wound discharge, urinary tract infection and respiratory tract infection-due to operative intervention and the neonatal effects of sepsis like –increased neutrophil count and increased C-reactive protein are equally distributed among the prophylactic, short course antibiotic 2 dose regimen and the regular 3 days-6 dose regimen. ◉ With the increasing fear of antibiotic resistance world wide, decreased usage in terms of 2 doses is the need of the hour regimen. ◉ Prophylactic 2 dose regimen is also cost effective-in terms of lesser usage of disposables & syringes also in lesser need of human resources and decreased contact time of the patient with the health care worker, especially during the pandemics