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.

Citation:

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.