Cefazolin Monotherapy versus Cefazolin with Azithromycin Prophylaxis in Non-Emergency Caesarean Section Infection of Pregnant Women: A Randomized Clinical Trial

Document Type : Original Article

Authors

1 Assistant Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Yasuj University of Medical Sciences, Yasuj, Iran.

2 Resident, Department of Obstetrics and Gynecology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

3 Assistant Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Hormozgan University of Medical Sciences, Hormozgan, Iran.

4 Resident, Department of Obstetrics and Gynecology, School of Medicine, Iran university of Medical Sciences, Tehran, Iran.

5 Gynecologist, Department of Obstetrics and Gynecology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

10.22038/ijogi.2025.78938.6042

Abstract

Introduction: 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 infection, antibiotics are used as prophylactic regimens. The present study was conducted with aim to compare the efficacy of single-dose prophylaxis of cefazolin and cefazolin plus azithromycin in non-emergency cesarean section infection.
Methods: This randomized single-blind clinical trial study was conducted in 2003 on 204 pregnant women who underwent non-emergency cesarean section at Mahdieh hospital affiliated to Shahid Beheshti University of Medical Sciences, Tehran. Patients were randomly assigned to the two groups of: intervention (receiving intravenous cefazolin and azithromycin) and control (receiving a single dose of cefazolin as prophylaxis) (n=102 in each group). Demographic and clinical information of the patients was recorded. Data were analyzed using SPSS (version 22) and Chi-square, Mann-Whitney, and logistic regression. P<0.05 was considered significant.
Results: The intervention and control groups were similar in terms of age, body mass index, gestational age, smoking, incision type, previous abdominal surgery or cesarean section, mean surgical length, and previous wound infection (p>0.05). The frequency of surgical site infection (p=0.005), fever (p=0.008), feeling pain following touch (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 compared to cefazolin alone can be effective in controlling surgical site infection in patients.

Keywords

Main Subjects

References

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The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 27, Issue 12
February 2025
Pages 1-10

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