Single Versus Multiple Doses Antibiotic Prophylaxis for Elective Caesarean Section at the Korle Bu Teaching Hospital

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Abstract Objective To compare the effectiveness of single dose to multiple doses antibiotic prophylaxis for elective caesarean section in Korle-Bu Teaching Hospital.Design Randomized non-inferiority comparative studySetting and population Eighty-six (86) pregnant women admitted for elective caesarean section and treated with single dose antibiotic and 86 pregnant women admitted for elective caesarean section and treated with multiple doses antibiotic in Korle-Bu Teaching Hospital, Ghana.Methods This study was randomized into two groups. Group A were given single dose of Amoxicillin-clavulanate potassium and metronidazole while group B were given multiple doses. The patients were examined on postoperative day 3, 14, 42 for signs of wound infection and endometritis. Statistical analysis was done using the student t-test and the chi-square test. Results were presented in cumulative incidence and as odds ratio together with 95% confidence intervals and P-value. Main outcome Effectiveness of single dose to multiple doses antibiotic prophylaxis for elective caesarean sectionResults: The SSI over the study period was 9.4%. All infections were superficial incisional SSI. Six (7.1%) and 10(11.6%) of the patients in the single dose and multiple dose arm respectively had wound infection. A statistically non-significant difference of 4.5% (difference 4.5: 95% CI -13.1- 4.1) (p = 0.305) was observed. Conclusions These results suggest that a single prophylactic intravenous dose of Amoxicillin-clavulanic acid 1.2g and Metronidazole (500mg) given before caesarean section is non-inferior to a multiple dose regimen with regards to post caesarean section SSI.

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