Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Routine Antibiotic Prophylaxis After Vaginal Birth

Cochrane; 2017 Nov 13; Bonet, et al

The routine administration of antibiotics may reduce the risk of endometritis after uncomplicated vaginal birth, according to a recent Cochrane review. The review included 1 randomized controlled trial (RCT) and 2 quasi-RCTs with 1,779 women who had uncomplicated vaginal birth, comparing different antibiotic regimens with placebo or no treatment. Researchers found:

  • Routine antibiotic administration reduced the number of women with endometritis by 70% (2 trials, n=1,364 women).
  • However, the use of antibiotics did not reduce the incidence of urinary tract infections, wound infections after episiotomy, or length of maternal hospital stay.
  • There was no difference between groups for skin rash due to antibiotics.
  • The cost of care was higher in the group that did not receive antibiotic prophylaxis.


Bonet M, Ota E, Chibueze CE, Oladapo OT. Routine antibiotic prophylaxis after normal vaginal birth for reducing maternal infectious morbidity. Cochrane Database of Syst Rev. 2017, Issue 11. Art. No.: CD012137. doi:10.1002/14651858.CD012137.pub2.