Evaluation of cefazolin monotherapy versus single-dose prophylaxis of cefazolin plus azithromycin in non-emergency cesarean section infection in pregnant women: a randomized clinical trial

Articles in Press

Document Type : Original Article

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hemat street

10.22038/ijogi.2025.78938.6042

Abstract

Background: The risk of infection in pregnant women with cesarean section is higher than that of pregnant women with vaginal delivery. To reduce the risk of this infection, some antibiotic prophylaxis regimens are used. The aim of the present clinical trial is to compare the efficacy of single-dose prophylaxis of cefazolin and cefazolin plus azithromycin in non-emergency cesarean section infection in Iranian pregnant women.

Methods: In this randomized, single-blind clinical trial, 204 pregnant women who underwent non-emergency cesarean section in 2022 at Mahdieh Hospital affiliated with Shahid Beheshti University of Medical Sciences, Tehran were enrolled in the study. Patients were randomly divided into two groups: the intervention group (n = 102) who received intravenous cefazolin and azithromycin, and the control group (n = 102) who received a single dose of cefazolin as prophylaxis. Demographic and clinical data including age, body mass, gestational age, previous cesarean section or abdominal surgery, smoking, type of incision, length of surgery, and previous wound infection were recorded.

Results: Age, body mass, gestational age, smoking, incision type, previous abdominal surgery or cesarean section, mean surgical length, and previous wound infection were similar between the intervention and control groups (p<0.05). The incidence of surgical site infection (p=0.005), fever (p=0.008), tenderness (p=0.005), endometritis (p=0.03), and hospitalization (p=0.003) was significantly lower in the intervention group than in the control group.

Conclusion: The use of cefazolin in combination with azithromycin as prophylaxis can be effective in controlling surgical site infection in patients compared to cefazolin alone.

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The Iranian Journal of Obstetrics, Gynecology and Infertility

Articles in Press, Accepted Manuscript
Available Online from 08 February 2025

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