Please wait a minute...
Clinical and Experimental Obstetrics & Gynecology  2021, Vol. 48 Issue (1): 31-36    DOI: 10.31083/j.ceog.2021.01.2182
Systematic Review Previous articles | Next articles
Timing of prophylactic antibiotic use during elective caesarean section: a meta-analysis of randomised controlled trials
Shi-Fu Hu1, Ying-Ying Wang2, Yan-Qing Wu2, Qiong Yu3, *()
1Obstetrics and Gynecology Department, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 Hubei, P. R. China
2Family Planning Research Institute, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 Hubei, P. R. China
3Reproductive Medicine Center, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, 430030 Hubei, P. R. China
Download:  PDF(2031KB)  ( 108 ) Full text   ( 20 )
Export:  BibTeX | EndNote (RIS)      
Abstract  
Perioperative antibiotic therapy is recommended to reduce the incidence of infection after caesarean section. However, the optimal timing of prophylactic antibiotic administration in such cases remains controversial. With this meta-analysis, we aimed to evaluate the safety and efficacy of prophylactic antibiotic therapy before skin incision versus after umbilical cord clamping in patients undergoing elective caesarean section. We searched the PubMed, EMBASE, Cochrane Library and Web of Science databases for randomised controlled trials (RCTs) published between January 1, 2000 and July 1, 2020. The 1101 initially identified references were narrowed to 10 RCTs involving 5020 women for the final analysis. Briefly, we determined that prophylactic antibiotic therapy before skin incision not only reduced the incidence of postpartum endometritis [relative risk (RR), 0.56; 95% confidence interval (CI), 0.34-0.92; P = 0.02), but also decreased the rate of total infectious morbidity (RR, 0.79; 95% CI, 0.64-0.98; P = 0.03) when compared to antibiotic therapy after umbilical cord clipping. However, the two timings of antibiotic administration did not lead to significant differences in the incidence of wound infection (RR, 0.73; 95% CI, 0.54-1.00; P = 0.05), maternal febrile morbidity (RR, 1.20; 95% CI, 0.67-2.14; P = 0.54), neonatal sepsis (RR = 0.65; 95% CI, 0.37-1.13; P = 0.13), septic workup (RR, 0.89; 95% CI, 0.67-1.18; P = 1.00) or neonatal intensive care unit admission (RR, 0.87; 95% CI, 0.69-1.09; P = 0.23). In conclusion, the prophylactic administration of antibiotics before a skin incision is made for an elective caesarean section can significantly decrease the incidence of total infectious morbidity and postpartum endometritis.
Key words:  Elective caesarean section      Prophylactic antibiotic therapy      Timing      Randomised controlled trial      Meta-analysis     
Submitted:  07 June 2020      Revised:  06 September 2020      Accepted:  09 September 2020      Published:  15 February 2021     
Fund: 81701509/National Natural Science Foundation of China
*Corresponding Author(s):  Qiong Yu     E-mail:  cmuyuqiong@163.com

Cite this article: 

Shi-Fu Hu, Ying-Ying Wang, Yan-Qing Wu, Qiong Yu. Timing of prophylactic antibiotic use during elective caesarean section: a meta-analysis of randomised controlled trials. Clinical and Experimental Obstetrics & Gynecology, 2021, 48(1): 31-36.

URL: 

https://ceog.imrpress.com/EN/10.31083/j.ceog.2021.01.2182     OR     https://ceog.imrpress.com/EN/Y2021/V48/I1/31

[1] Dubravko Habek, Matija Prka, Anto Čartolovni, Anis Cerovac, Domagoj Dokozić. Caesarean section between doctrine to heresis. Medicoethical and deontological view of caesarology: an opinion[J]. Clinical and Experimental Obstetrics & Gynecology, 2021, 48(1): 1-4.
[2] Y. Sun, X. Chen, X. Yuan, L. Xu, Y.C. Jin, T.H. Ji, X.L. Wang, H.H. Dai, W.J. Cheng. Levonorgestrel intrauterine system versus oral progestin for preventing the recurrence of endometrial polyps after hysteroscopic resection: A meta-analysis of 19 randomized controlled trials[J]. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(6): 821-828.
[3] J. Dun, X. Wang, J. Yang, J. Xu. Clinical practice guidelines on polycystic ovary syndrome: a systematic review and comparative meta-analysis[J]. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(4): 465-471.
[4] Y. Zheng, G. Niu, H. Zhang, W. Lu, Z. Liu. Estrogen replacement therapy is not a recommended therapy for postmenopausal women with coronary heart disease: a meta-analysis[J]. Clinical and Experimental Obstetrics & Gynecology, 2019, 46(2): 219-226.
[5] U. Indraccolo, R. Ventrone, G. Scutiero, P. Greco, S.R. Indraccolo. Interventions for treating amniotic fluid embolism: a systematic review with meta-analysis[J]. Clinical and Experimental Obstetrics & Gynecology, 2017, 44(5): 666-677.
No Suggested Reading articles found!