Cesarean Section

Cesarean surgical site infections can be prevented by proper preoperative antibiotic prophylaxis. Differences in antibiotic selection in clinical practice exist according to clinicians preferences despite clear guidelines on preoperative antibiotic prophylaxis. The present study thus attempted to understand the antibiotic usage pattern among Lower segment Cesarian section (LSCS) patients in Hyderabad. Subjects for study were patients attending private hospitals in Hyderabad. Case records of LSCS patients who were prescribed antibiotics were used for extraction of relevant data. Other gynecological patients were excluded from the study.  The mean age of LSCS patients was 24.57 years. The average number of antibiotics per patient was 2.2. The average number of other drugs per encounter was 6.45. The most commonly prescribed antibiotic was Ceftriaxone followed by Metronidazole. More than 80% of infections were treated with a combination of antimicrobials. In present study, all antibiotics were prescribed in generic name. Polypharmacy was evident from the study. All the antibiotics were given in multiple doses and the administration of antibiotics were given before incision in all patients. Considering spectrum of activity, sensitivity against resistant pathogens and less toxicity, third generation cephalosporins, especially ceftriaxone has been widely used in India for surgical prophylaxis. The common use of ceftriazone and metronidazole could be related to the possibility of mixed infections in LSCS patients. The overall antibiotic usage in LSCS patients were acceptable as per WHO “World Health Organization” standards and the general gynecological practice around the globe. Properly designed studies to access safety and efficacy of single dose vs multiple dose of antibiotics, pre and post incision antibiotic administration is need of the hour.