Surgical Site Infection Following Episiotomy Repair in Relation to Routine Use of Postpartum Antibiotic Prophylaxis in Low Risk Population: A Randomized Controlled Trial

Document Type : Original Article

Authors

1 Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt

2 Department of Obstetrics and Gynecology, Faculty of Medicine, Benadir University, Somalia, Egypt (M.B.B.ch)

Abstract

Background: Antibiotic prophylaxis may lower the inci-dence of wound infections following an episiotomy, espe-cially in circumstances like midline episiotomy, incision extension, or environments with a high baseline risk of infection following vaginal delivery, which are linked to a higher risk of postpartum perineal infection. Neverthe-less, there is conflicting data at this time about the benefit of prophylactic antibiotics in avoiding infections after an episiotomy.   
Objective: Evaluation of whether regular prophylactic antibiotic medication to women after an uncomplicated vaginal delivery, as opposed to not administering any an-tibiotic prophylaxis, lowers postpartum maternal infec-tious morbidities and improves outcomes.  
Methods: A total of 200 pregnant women with who un-derwent elective episiotomy repair were enrolled and di-vided into two equal groups; study group received oral antibiotics in a dose of 625gm twice daily for 3 days af-ter delivery and control group didn't receive postpartum antibiotics. We followed up her through a telephone call weekly for 6 weeks asking about fever, discharge, vaginal pain, dysuria, vulval swelling, redness and pelvic pain. Maternal readmission to hospital, puerperal sepsis, uri-nary tract infection, endometritis, serious infectious com-plications was compared between study groups.   
Results: No differences were noted between study groups regarding all study parameters. Routine antibiotics after episiotomy had no role in prophylaxis against wound complications, maternal fever, puerperal infection and maternal readmission. 
Conclusion: Administration of prophylactic systemic an-tibiotic post episiotomy is not effective to prevent wound infection.

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