A single shot of prophylactic antibiotics can protect women who give birth with the aid of forceps or vacuum extraction.
According to a recent study, giving women one dose of a preventive antibiotic after childbirth involving forceps or vacuum extraction could prevent almost half of maternal infections, which is equal to more than 7,000 per year in the UK and approximately 5,000 per year in the US.
British research was conducted on 3,420 women older than 16-years, and who had undergone operative vaginal birth at 36 weeks or higher gestation.
Within six hours of delivery, one group was given a single shot of Augmentin (amoxicillin and clavulanic acid), and the other was given a placebo saline shot. They were observed for infection over the next six weeks. The chances of the placebo group being infected were 58% higher as compared to the group receiving the antibiotic shot. The chances of whole body infection were also 44% higher in women receiving placebo shots (as compared to the other group). Moreover, the women receiving the antibiotic shot were less likely to require pain medication. The researchers calculated that for each additional 100 doses of antibiotic used preventively, 168 doses of antibiotics to treat infections would be saved.
There are no guidelines or evidence on the use of antibiotic prophylaxis and vaginal delivery. But, looking at the results, lead author, Dr. Marian Knigh said, “These findings highlight the urgent need to change current WHO [World Health Organization] antibiotic guidelines and other guidance from [organizations] in the UK, North America, and Australasia, that do not recommend routine antibiotic prophylaxis for assisted childbirth."
The benefit is more likely to impact the UK than the US due to the difference in the number of assisted birth: about 12.5% in the UK and 4% in the US.
#ANODE trial of prophylactic antibiotic after operative vaginal birth shows not only a reduction in infection but also less perineal pain or wound breakdown, less need for pain relief and need for fewer GP/midwife/hospital visits at six weeks postpartum https://t.co/zdpqHLhxEJ— Marian Knight (@Marianfknight) May 13, 2019
However, it is essential to remember that women who are allergic to penicillin or any of the constituents of amoxicillin and clavulanic acid cannot be given the dose of prophylactic antibiotics. Thus an allergy test or collecting information on the medical history of the women is imperative.
If one dose of antibiotic can benefit in so many ways - reduce the chance of infection, reduce the need for painkillers post-delivery, lessen chances of problems with the wound, then why not give it? In fact, one shot can reduce the overall intake of antibiotics.