Antibiotic Prophylaxis in Caesarean Section

Objective: To study the use of prophylactic antibiotics in caesarean section (CS). Methods: A prospective, cross-sectional study was conducted at Western Regional Hospital of Nepal. Results: This study included a total of 188 eligible women undergoing CS. The result showed that 42.6 % of the women were of 20-24 yrs of age followed by 31.9 % of 25-29 yrs. The indications for CS included cephalopelvic disproportion (62.2 %), oligohydraminos (20.2 %), breech presentation (18.1 %) and fetal distress (10.1 %). Failed induction, multiple pregnancy, failure to progress, dystocia and preeclampsia/eclampsia were relatively rare indications. Elective and emergency CS was common between the age group 20-24 and 25-29 yrs whereas emergency CS was more common than elective in the age group below 20 yrs and above 39 yrs. In 99.5 % cases metronidazole, 50.5 % cases ciprofloxacin and 50.5 % cases gentamycin was used for prophylaxis. Of the total women 50 % of the women got 3 antibiotics for prophylaxis followed by 47.9 % of them who got 2 antibiotics for prophylaxis. The average length of hospital stay was found to be 6.71 days. Conclusion: The results obtained from the study revealed that CS was prevalent in Western region of Nepal. But there was no proper guideline for antibiotic prophylaxis for CS in the hospital. Therefore, there is need of a standard guideline to promote rational use of antibiotics for prophylaxis in CS.Key Words: Caesarean section, Antibiotic prophylaxis, Nepal