Prophylactic antibiotics for the prevention of postpartum infectious morbidity in women infected with human immunodeficiency virus: a randomized controlled trial.

Abstract

OBJECTIVE:

The purpose of this study was to determine the effect of intrapartum prophylactic antibiotics in the prevention of postpartum sepsis in laboring women who were infected with HIV.

STUDY DESIGN:

In a double-blind, randomized trial that was conducted in Durban (South Africa), pregnant women who were infected with HIV in whom vaginal delivery was anticipated were randomized to receive either a single dose of cefoxitin (2 g) or placebo intrapartum. Signs of sepsis were evaluated within 72 hours and at 1 and 2 weeks postpartum.

RESULTS:

Of the 424 women who were enrolled, 213 women received cefoxitin, and 211 women received placebo. Both groups were comparable in all baseline parameters. The overall sepsis rate was 19% (40/211 women) in the placebo group and 16.9% (36/213 women) in the cefoxitin group (P = .581). There was a 53% reduction in risk of postpartum endometritis in the cefoxitin group (95% confidence interval, 0.24-0.9).

CONCLUSION:

The use of prophylactic intrapartum cefoxitin in HIV-infected women reduces the risk of postpartum endometritis.

• Authors: H M Sebitloane, J Moodley, T M Esterhuizen
• Journal: American journal of obstetrics and gynecology (Am J Obstet Gynecol) Vol. 198 Issue 2 Pg. 189.e1-6 (Feb 2008) ISSN: 1097-6868 [Electronic] United States
• PMID: 17997391 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Bacterial Agents
• Cefoxitin

Topics

• Adult
• Anti-Bacterial Agents (administration & dosage, therapeutic use)
• Antibiotic Prophylaxis
• Cefoxitin (administration & dosage, therapeutic use)
• Double-Blind Method
• Drug Administration Schedule
• Endometritis (mortality, pathology, prevention & control)
• Female
• HIV Infections
• Humans
• Incidence
• Pregnancy
• Pregnancy Complications, Infectious
• Puerperal Disorders (mortality, pathology, prevention & control)
• South Africa