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6. Pattern of antimicrobial use in caesarean section in a tertiary care hospital in rural south India

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Author(s): J. Heethal | N. Sarala | T.N. Kumar | M. Hemalatha

Journal: International Journal of Pharmaceutical and Biomedical Research (IJPBR)
ISSN 0976-0350

Volume: 01;
Issue: 02;
Start page: 57;
Date: 2010;
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Keywords: Antimicrobials | Cesarean section | Urinary tract infection | Wound infection | South India

ABSTRACT
Use of antimicrobials in caesarean section has become an accepted practice to minimize the incidence of post operative complications. Not many studies are available in India regarding the use of antimicrobial in caesarean section, hence this study. The study aims at finding the pattern of use of antimicrobial prophylaxis in caesarean section and also the frequency of post operative morbidity. This study is a retrospective case series analysis which included seventy five patients undergoing caesarean section admitted to the obstetrics and gynaecology department of Sri R.L.Jalappa hospital and research centre. Relevant information on each patient was collected according to the proforma designed for the study. Antimicrobial used, their dose dosage schedule were recorded. Investigations like pus, blood and urine culture and sensitivity was recorded for patients with post operative complications. Change of antimicrobial following culture sensitivity report was noted. In our analysis, most of the patients came from low socioeconomic status. We observed the use of third generation cephalosporin like ceftriaxone or cefotaxime and metronidazole in most of the patients. Two drugs or three drug combinations were used which commonly included third generation cephalosporin and metronidazole with gentamicin being added in three drug combinations. Thirty patients had post operative complications which included wound infection, urinary tract infection and fever. E. coli were the common organism isolated which was resistant to third generation cephalosporin and sensitive to amikacin. In conclusion, periodic surveillance of antimicrobial prophylaxis is essential to detect the emergence of antibiotic resistance.
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