Single dose antibiotic with pre-operative vaginal preparation versus multiple doses of prophylactic antibiotics in respect to surgical site infection in elective caesarean section

Abstract

Introduction: Surgical site infection (SSI) is one of the infectious complications that follow caesarean section(C/S). Perioperative prophylactic antibiotics and preoperative vaginal preparation with povidone-iodine solution are perioperative strategies for reducing its risk following C/S. Therefore, this research aimed to compare the incidence of surgical site infection following the use of a single dose of antibiotic with preoperative vaginal preparation versus multiple doses of antibiotics in elective C/S. Study design: A blinded randomized controlled trial. Methods: Two hundred eligible participants were randomized into two arms (100 each). Arm A (a single dose of intravenous antibiotics with preoperative vaginal preparation and placebo). Arm B (multiple doses of antibiotics). Data entry was done using statistical package of social sciences version 23. The fisher’s exact and independent t- tests were used as tests of significance where applicable. A P< 0.005 is considered significant. Results: Incidence of surgical site infection in elective C/S in Ekiti State University Teaching Hospital was 2.5%. There was no significant statistical difference in the incidence of SSI between the two Arms (2% versus 3%, p-value is 0.651). The mean cost of antibiotics and hospital admission are lower in Arm A  (#3,398.09) and ( #75,820.00) respectively compared to (#4,836.60) and (#77,445.70) respectively in Arm B. There was a significant statistical difference in the mean cost of antibiotic treatment (P =value 0.0001) and admission (P=value 0.001) respectively. Conclusion: Single dose of intravenous antibiotic in combination with preoperative vaginal preparation is comparable with multiple doses in preventing SSIs in elective C/S.

Keywords: surgical site infections, prophylactic antibiotics, placebo, preoperative vaginal preparation, elective caesarean section.