Effectiveness of single versus multiple doses of antibiotics in elective cesarean section for prevention of post operative morbidity

Background: Caesarean section is one of the commonest major abdominal surgeries worldwide given to its increasing rate. The most common post-operative complication following caesarean section is considered as the infective morbidity. Many studies have shown a clear advantage of antibiotic prophylaxis in the reduction of postoperative infective morbidity. However, indiscriminate use of antibiotics is still being continued in many centres. This study was aimed at comparing the efficacy of single versus multiple doses of antibiotics in preventing postoperative morbidity following Elective caesarean section. Methods: This was a prospective comparative study that included 200 patients undergoing elective caesarean section at SNR District Hospital, Kolar, during the study period. These patients were divided into two groups, group 1 received single dose of Inj ceftriaxone 2gm I/V and group 2 received a single dose of Inj ceftriaxone 1 gm I/V within 30-60 mins of commencement of surgery followed by Inj ceftriaxone 1gm I/V BID for 5 days post-operatively. Patients were followed up prospectively for the development of infective morbidity in the form of surgical site infections. Results: Mean age, mean haemoglobin levels, and duration of surgery were comparable in patients with SSI in both groups. The incidence of surgical site infection was found to be 10% in the patients who received single dose antibiotic prophylaxis which was comparable with 9.5% in multiple dose group. Conclusions: Single-dose antibiotic prophylaxis is as effective as multiple-dose antibiotic prophylaxis in elective caesarean section in preventing post operative infective morbidity.