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 .
Cefazolin versus Cefazolin plus Metronidazole for Antibiotic Prophylaxis at Cesarean Section
Background Although prophylactic antibiotic medications have been shown to reduce the incidence of postoperative infectious morbidity after cesarean delivery , the most effective regimens have not been established . The purpose of this investigation was to compare the efficacy and costs of prophylaxis with cefazolin alone with cefazolin plus metronidazole . Methods Women undergoing cesarean delivery were r and omized to prophylaxis with 2 g cefazolin ( n = 81 ) or 1 g cefazolin plus 500 mg metronidazole  ( n = 79 ) . Postoperative infectious morbidity and the duration of hospitalization in the two groups were compared . Results Thirty-seven ( 23 % ) of 160 patients developed endomyometritis . There was a significant reduction in the number of postoperative infections ( 14 versus 32 % ) and hospital days ( 3.12 versus 4.46 ) with cefazolin and metronidazole prophylaxis ( P = 0.0064 versus P = 0.014 ) compared with cefazolin alone . The estimated antibiotic prophylaxis cost per person was less with cefazolin and metronidazole than with cefazolin alone ( $ 9.12 versus $ 26.73 ) . Conclusion Antibiotic prophylaxis with metronidazole and cefazolin results in fewer postoperative infections , decreased duration of hospitalization , and lower medication cost than cefazolin alone
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 .