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 .
Administration of cefazolin prior to skin incision is superior to cefazolin at cord clamping in preventing postcesarean infectious morbidity: a randomized, controlled trial.
OBJECTIVE The objective of the study was to determine whether the administration of cefazolin prior to skin incision was superior to administration at the time of umbilical cord clamping for the prevention of postcesarean infectious morbidity . STUDY DESIGN This was a prospect i ve , r and omized , double-blind , placebo-controlled trial . Study subjects received cefazolin 15 - 60 minutes prior to incision and controls received cefazolin at the time of cord clamping . The occurrence of endomyometritis , wound infection , total infectious morbidity , and neonatal complications were compared . RESULTS There were 357 subjects enrolled . No demographic differences were observed between groups . There were decreased total infectious morbidity in the study group ( relative risk [ RR ] = 0.4 , 95 % confidence interval [ CI ] 0.18 to 0.87 ) , decreased endometritis ( RR = 0.2 , 95 % CI 0.15 to 0.94 ) . No increase in neonatal sepsis ( P = .99 ) , sepsis workups ( P = .96 ) , or length of stay ( P = .17 ) was observed . CONCLUSION Administration of prophylactic cefazolin prior to skin incision result ed in a decrease in both endomyometritis and total postcesarean infectious morbidity , compared with administration at the time of cord clamping . This dosing did not result in increased neonatal septic workups or complications
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 .