Regarding surgical antibiotic prophylaxis for cesarean section, current evidence-based guidance recommends:

• A Antibiotics given only after umbilical cord clamping to avoid fetal exposure
• B A single dose of a first-generation cephalosporin administered within 60 minutes before skin incision ✓
• C Antibiotics started only if the membranes have been ruptured for more than 12 hours
• D Continuation of oral antibiotics for five days after surgery in all cases

Explanation

Randomized trials and meta-analyses show that administering a single dose of cefazolin or another first-generation cephalosporin within 60 minutes before skin incision significantly reduces post-cesarean endometritis and wound infection compared with administration after cord clamping, without harm to the neonate. Prophylaxis is indicated for all cesarean deliveries, elective and emergency alike. Prolonged postoperative antibiotics add no benefit in uncomplicated cases and promote resistance. The older teaching of waiting until cord clamping has been superseded by this evidence.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.