TUESDAY, May 14, 2019 (Pharmacist's Briefing) -- A single dose of a prophylactic antibiotic is beneficial after operative vaginal birth and reduces the risk for confirmed or suspected maternal infection, according to a study published online May 13 in The Lancet.
Marian Knight, M.B.Ch.B., M.P.H., from the University of Oxford in the United Kingdom, and colleagues conducted a randomized trial at 27 obstetric units involving 3,427 women aged ≥16 years. Participants were randomly assigned to receive either a single dose of intravenous amoxicillin and clavulanic acid (1,719 women) or placebo (1,708 women) following operative vaginal birth at 36 weeks of gestation or later. The primary outcome was confirmed or suspected maternal infection within six weeks of delivery.
The researchers found that compared with women assigned to placebo, significantly fewer women randomly assigned to amoxicillin and clavulanic acid had a confirmed or suspected infection (11 versus 19 percent; risk ratio, 0.58). In the placebo group, one woman reported a skin rash. Two women in the amoxicillin and clavulanic acid group reported other allergic reactions; one was considered a serious adverse event. There were reports of two other serious adverse events, neither was causally related to treatment.
"Further analysis of the mechanism of action of this single dose of antibiotic is needed to investigate whether earlier administration, prenatal administration, or repeated administration is likely to be more effective than the single intravenous dose administered three hours after women gave birth," the authors write.