Alka Murlidhar Patankar1 , Swati Patel2 , Prashaant Arun Uikey3 , Megha P. Tajne4 , Aashima Mittar Garg5
BACKGROUND There is an increasing incidence of caesarean section around the world. As caesarean section is associated with infectious complications, frequent and inappropriate use of all newly discovered antimicrobial drugs has led to the development of altered mechanisms and treatment failure or ineffective management of such patients which increase the rate of morbidity and mortality in mothers. Many guidelines and studies recommend single dose antibiotic prophylaxis for women undergoing elective or non-elective caesarean section. The aim of this study was to assess the effectiveness of ceftriaxone as prophylactic antibiotic in elective caesarean section patients. METHODS This study was carried out in Indira Gandhi Government Medical College and Hospital, Nagpur from 2017 to 2019. Approval from Institutional Ethics committee was taken prior to commencement of the study. Two hundred patients were included in the study from wards who fulfilled the inclusion criteria. They were divided into two groups, group 1 had hundred patients who received inj. Ceftriaxone as single dose prophylaxis after cord clamping. Group 2 of hundred patients received combination of inj. cefotaxime, metronidazole and gentamicin, which was administered for 2 days IV followed by oral Augmentin for 5 days Postoperatively. The efficacy was measured in terms of febrile morbidity, wound infection, duration of hospital stay, and cost of antibiotic. RESULTS Febrile morbidity was significantly less in group 1 compared to group 2. 3% from group 1 and 16% from group 2 had wound discharge and therefore, the difference was statistically significant (p=0.003). 2% from group 1 and 9% from group 2 presented with wound dehiscence (p=0.027). 74% from group 1 had a shorter hospital stay of 7 days (p=<0.001). Mean cost of antibiotic in group 1 was INR 98.68/- while that in group 2 was INR 662.68/-. So, the use of short-term antibiotic was cost effective and the difference was statistically significant (p<0.0001). CONCLUSION Short-term course of prophylactic antibiotic is very safe, cost effective, more convenient and effective in reducing maternal morbidity and post-operative hospital stays when compared to traditional use of combination of metronidazole, cefotaxime and gentamicin in elective low risk caesarean section cases.
