Prescribing practice for antibiotic prophylaxis for cesarean section in a teaching hospital in Brazil

Background: The contribution of antibiotic prophylaxis to reduce surgical wound infection and endometritis after cesarean section is well-known. Despite the knowledge about the effectiveness of antibiotic prophylaxis with this procedure, the administrative regimens are often inappropriate. Methods: The use of antibiotic prophylaxis in cesarean section was evaluated in a reference school hospital. Data were collected from medical records, and they correspond to the 9-month observation during 1995 and 1996. Results: The cesarean section rate was 26.4% in this period. The total procedures observed was 587. Antibiotic prophylaxis was prescribed in 358 procedures (61%). Cephalothin was the most prescribed drug (98.6%), with a regimen of 2 g intravenously after clamping of the umbilical cord and 2 more doses of 1g every 6 hours. Antibiotic prophylaxis was indicated more frequently in patients younger than 30 years and in those with rupture of membranes for more than 6 hours; such differences were significant (P < .05 and P < .00001, respectively). Conclusion: The prescribers met the hospital guidelines for antibiotic prophylaxis in only 37.1% of the cesarean sections performed. (Am J Infect Control 2002;30:341-5.)