Overuse of prophylactic antibiotics for elective caesarean delivery in Medani Hospital, Sudan

Background : Antibiotics for prophylaxis are widely used to reduce the risk of post-caesarean delivery infection. The dosage regimens are often inappropriate and may result in the appearance of drug-resistant organisms, which will increase the cost. Objectives: A cross-sectional study was conducted to investigate the prescribing patterns of prophylactic antibiotics for elective caesarean delivery (CD) at Medani Hospital, Sudan. Method : The medical records of women who underwent elective CD from April 2015 to June 2015 were reviewed retrospectively. Results : The main reasons for CD among these women (n=202) were repeat CD, breech and antepartum haemorrhage. The mean (±SD) age of the women was 28.7 (±6.2) years. Ceftizoxime was the most commonly prescribed antibiotic, prescribed for 63.9% of women.  It was used alone in 12.4% of cases, and in combination with gentamicin and metronidazole in 49.5% of cases.  Cefuroxime was used in combination with gentamicin and metronidazole in 26.7% of women, and in combination with metronidazole only in 9.4% of women, making the overall percentage 36.1%. Antibiotics were administered for 5 days in 32.7% of cases. 91.1% of women received antibiotic prophylaxis after clamping of the cord. All women received oral antibiotic prophylaxis on discharge for five to seven days. Oral cefuroxime in combination with metronidazole was the most preferred regime (77.2 %). Conclusions :  The current study shows overuse of antibiotics for elective CD. Injectable ceftizoxime in combination with gentamicin and metronidazole after cord clamping was the most commonly prescribed regime.