Single-Dose vs. Triple- dose Antibiotic Prophylaxis in Preventing Postoperative Infection in Elective Cesarean Section: A Randomized Controlled Trial

Background & Objective: To reduce complications, the use of antibiotics should not be increased. This study was conducted with aim to compare a single dose vs. Triple-dose antibiotics prophylaxis to prevent postoperative infection in elective cesarean section.Materials & Methods: This double-blinded randomized clinical trial study was conducted on pregnant women who underwent elective cesarean section who were randomly divided into two groups. The first group (n=60) received 2 gr intravenous Cefazolin as a single dose one hour before the operation, and the second group (n=60) received one dose one hour before the operation and two doses every 8 hours after the operation (a total of three doses). All patients were examined for postoperative infection at the end of the first week, the second week after the operation, and the end of the first month after the cesarean section according to the questionnaire. The primary outcome was wound infection (purulent discharge, Cellulitis), while the secondary outcomes were clinical endometritis, adhesion, urine infection, and postoperative fever.Results: There was no statistical difference between the two groups in the incidence of cellulitis (5% vs. 1.7%; P=0.238), adhesion (1.7% vs. 3.3%, P=0.559, purulent discharge (3.3% vs 0%, P=0238) . No cases of urine infection and postoperative fever were reported in any of the two groups.Conclusion: Single-dose antibiotic prophylaxis using cefazolin has comparable efficacy to multi-dose antibiotic regimens and potentially offers a cost-effective advantage.