Prophylactic antibiotics for the prevention of postpartum infectious morbidity in women infected with human immunodeficiency virus: a randomized controlled trial
Sebitloane, H.M.; Moodley, J.; Esterhuizen, T.M.
American Journal of Obstetrics and Gynecology 198(2): 189.e1-6
2008
ISSN/ISBN: 0002-9378 PMID: 17997391 DOI: 10.1016/j.ajog.2007.08.053Document Number: 198524
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. 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. 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). The use of prophylactic intrapartum cefoxitin in HIV-infected women reduces the risk of postpartum endometritis.
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