How effective are prophylactic antibiotics for women undergoing caesarean section?
Prophylactic antibiotics given to all women undergoing elective or non-elective caesarean section is clearly beneficial for women but there is uncertainty about the consequences for the baby. Studies did not assess potential adverse effects on the baby, and the rates of oral candidiasis were not reported. It was also unclear whether the routine use of antibiotics would contribute to increasing drug resistant strains of bacteria.
Women undergoing caesarean section have a 5-fold to 20-fold greater chance of an infection compared with women who give birth vaginally. These infections can be in the organs within the pelvis, around the surgical incision and sometimes in the urinary tract. The infections can be serious, and very occasionally can lead to the mother’s death. The potential benefits of reducing infection for the mother need to be balanced against adverse effects, such as nausea, vomiting, skin rash and rarely allergic reactions in the mother, and the risk of oral candidiasis and any effect of antibiotics on the “friendly” gut bacteria in the baby.