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Infectious Diseases in Obstetrics and Gynecology
Volume 6 (1998), Issue 5, Pages 220-223
Clinical Study

Incidence of Postpartum Endomyometritis Following Single-Dose Antibiotic Prophylaxis With Either Ampicillin/Sulbactam, Cefazolin, or Cefotetan in High-Risk Cesarean Section Patients

1The New York University Medical Center, New York 10016, NY, USA
2The New York Hospital-Cornell Medical Center, New York, NY, USA

Received 24 August 1998; Accepted 3 November 1998

Copyright © 1998 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective: To assess the efficacy of Single-dose antibiotic prophylaxis against postpartum endomyometritis in high-risk cesarean section patients.

Design: Patients were administered one of three single-dose antibiotic regimens following umbilical cord clamping after cesarean section delivery.

Setting: Prospective randomized trial at a university-based hospital.

Patients: The study evaluated 293 consenting women undergoing cesarean section who had either experienced labor for a duration of ≥ 6 hr or rupture of amniotic membranes.

Main outcome measures: Development of postpartum endomyometritis.

Results: The incidence of postpartum endomyometritis was 7/95 (7.4%) following the ampicillin/sulbactam regimen, 14/98 (14.3%) after the cefazolin regimen, and 11/99 (11.1%) after the cefotetan regimen. There was no significant difference in postpartum infection among the three study arms. In addition, the incidence of endomyometritis in the three single-dose study arms was not higher than previously noted in studies where three doses of antibiotic were administered.

Conclusion: Single-dose antibiotic prophylaxis should replace the standard triple-dose therapy for uninfected women undergoing cesarean section who are at risk for postoperative endomyometritis. Ampicillin/sulbactam, cefazolin, and cefotetan are all reasonable antibiotic choices for single-dose therapy.