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Keywords:

  • Antibiotics;
  • caesarean section;
  • endometritis;
  • pregnancy;
  • prophylaxis;
  • surgical site infections

Please cite this paper as: Lamont R, Sobel J, Kusanovic J, Vaisbuch E, Mazaki-Tovi S, Kim S, Uldbjerg N, Romero R. Current debate on the use of antibiotic prophylaxis for caesarean section. BJOG 2011;118:193–201.

Caesarean delivery is frequently complicated by surgical site infections, endometritis and urinary tract infection. Most surgical site infections occur after discharge from the hospital, and are increasingly being used as performance indicators. Worldwide, the rate of caesarean delivery is increasing. Evidence-based guidelines recommended the use of prophylactic antibiotics before surgical incision. An exception is made for caesarean delivery, where narrow-range antibiotics are administered after umbilical cord clamping because of putative neonatal benefit. However, recent evidence supports the use of pre-incision, broad-spectrum antibiotics, which result in a lower rate of maternal morbidity with no disadvantage to the neonate.