Background:
Postcesarean wound infection is a leading cause of prolonged hospital stay. Considerable debates still exist regarding choice of antibiotics, dose, and duration of use.
Objectives:
The objective is to compare the efficacy of 2 doses of amoxicillin-clavulanic acid versus a 7 days combination of amoxicillin-clavulanic acid and metronidazole as prophylactic antibiotics following cesarean section (CS).
Methodology:
It was a randomized controlled trial that was conducted among 160 women undergoing CS at Aminu Kano Teaching Hospital. Women were randomized into two groups. Group I (study group) received 2 doses of 1.2 g amoxicillin-clavulanic acid. Group II (control group) received a 7 days course of amoxicillin-clavulanic acid and metronidazole. The data obtained were analyzed using SPSS version 17. Categorical (qualitative) variables were analyzed using Ch-square test and Fisher’s exact test as appropriate while continuous (quantitative) variables were analyzed using independent sample
t
-test.
P
< 0.05 was considered statistically significant.
Results:
There was no statistically significant association in the occurrence of fever (12.8% vs. 15.8%,
P
= 0.6), wound infection (6.4% vs. 10.5%,
P
= 0.36), endometritis (7.7% vs. 11.8%,
P
= 0.38), UTI (6.4% vs. 5.3%,
P
= 1.00), mean duration of hospital stay (129.7 vs. 134.2 h,
P
= 0.48), and neonatal outcomes between the two groups. There was statistically significant difference in the mean cost of antibiotics (₦2883/US$9.5 vs. ₦7040/US$23.1,
P
< 0.001) and maternal side effects (10.3% vs. 26.3%,
P
< 0.001) between the study and the control groups, respectively.
Conclusion:
This study found no statistically significant difference in infectious morbidity, duration of hospital stay, and neonatal outcomes when two doses of amoxicillin-clavulanic acid was compared with a 7 days course of prophylactic antibiotic following CS. The use of two doses of amoxicillin-clavulanic acid has the advantages of reduced cost and some maternal side effects. The two doses were cheaper with minimal side effects.
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