The results of a randomized clinical trial conducted in the United Kingdom suggest a single dose of preventive antibiotics after assisted childbirth could cut the number of maternal infections by nearly half.
In the first-of-its-kind trial, women who received a single dose of intravenous (IV) antibiotics following operative vaginal birth—which involves the use of forceps or a vacuum to extract the fetus—were 42% less likely to have any infection than women who received a placebo, and 56% less likely to have a systemic infection. Furthermore, trial investigators found universal prophylaxis could spare antibiotic use. They estimate that for each additional 100 doses of antibiotic used in prophylaxis, 168 treatment doses would be avoided—a reduction of 17%.
The results are significant because the World Health Organization (WHO) currently recommends prophylactic antibiotics for women undergoing caesarean section but not for women undergoing operative vaginal birth, citing the lack evidence of a benefit and the importance of antibiotic stewardship. The investigators say the findings, which were published yesterday in The Lancet,indicate those recommendations need modification.
Concerns about maternal infections, sepsis
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