Although current guidelines for antibiotic prophylaxis recommend the administration of narrow-spectrum antibiotics ( cefazolin ) after clamping of the umbilical cord , the data suggest that antibiotic administration before surgical incision or the use of extended-spectrum regimens ( involving azithromycin or metronidazole ) after cord clamp may reduce postcesarean maternal infection by up to 50 % .
: The use of either cefazolin alone before surgical incision or an extended-spectrum regimen after cord clamp seems to be associated with a reduction in  postcesarean maternal infection .
The Microbiology of Post‐Cesarean Wound Morbidity
Objective : To determine the microbiology of wound morbidity following cesarean deliveries . Methods : Nine hundred thirty‐nine wounds in post‐cesarean patients were followed prospect ively . Aspirates from the abdominal incision were collected if the wounds developed erythema , in duration , or pain and had demonstrable fluid collection noted on ultrasound . Cultures were also obtained of wound exu date s when there was spontaneous separation of the skin . Gram stains were performed concomitantly with culture . Results : The cumulative incidence of  post‐cesarean wound morbidity between September 1990 and June 1991 was 6.9 % ( 65 of 939 ) , and the rate of culture‐positive wounds was 72 % ( 47 of 65 ) . Ureaplasma urealyticum was the most frequent isolate at a rate of 62 % ( 29 of 47 ) , followed by coagulase‐negative staphylococci at 32 % ( 15 of 47 ) and Enterococcus faecalis at 28 % ( 13 of 47 ) . Gram stains of the exu date s obtained were used to predict microbiologic results . Organisms present on Gram stain yielded a sensitivity of 0.55 , specificity of 1.0 , positive predictive value of 1.0 , and negative predictive value of 0.71 when used to predict positive culture results for bacterial wound infection other than with genital mycoplasmas . White blood cell counts greater than ten per 400 × high‐power fields yielded a sensitivity of 0.83 , specificity of 0.72 , positive predictive value of 0.89 , and negative predictive value of 0.62 when used to predict wound infection including genital mycoplasmas . Conclusions : Genital mycoplasmas are the most prevalent bacterium in post‐cesarean wound infections in this population . If genital mycoplasmas are pathogenic in this setting , then the Gram stain may be useful in predicting wound microbiology . More research is needed on the pathogenic role of genital mycoplasmas in wound infections
Although current guidelines for antibiotic prophylaxis recommend the administration of narrow-spectrum antibiotics ( cefazolin ) after clamping of the umbilical cord , the data suggest that antibiotic administration before surgical incision or the use of extended-spectrum regimens ( involving azithromycin or metronidazole ) after cord clamp may reduce postcesarean maternal infection by up to 50 % .
: The use of either cefazolin alone before surgical incision or an extended-spectrum regimen after cord clamp seems to be associated with a reduction in  postcesarean maternal infection .