Antibiotics prevent life-threatening infections after birth

Antibiotics to protect against sepsis?

Many women suffer from painful and sometimes life-threatening infections after the assisted birth of their child. Antibiotic preventive treatment could save women affected by such problems.

A recent study by the internationally renowned Oxford University found that antibiotic prevention can protect women from dangerous infections after assisted work. The results of the study were published in the English language newspaper "The Lancet".

More than 3,400 women participated in the study

The current study includes 3,420 women who gave birth to a baby in 27 different establishments across the UK. A single dose of antibiotics within six hours of delivery reduced the number of infections in women whose babies delivered by half, either with special tweezers or with a suction cup.

Results could prevent more than 200,000 infections each year

The results could lead to more than 200,000 maternal infections a year worldwide. They will be included in the new recommendations published this year by the Royal College of Obstetricians and Gynecologists of the United Kingdom. This will have a huge impact on women, not just on the infection rate. Women who have received antibiotics also have significantly less perineal pain and sutured stitches. As a result, affected women also have fewer problems feeding their baby despite the pain.

Why does the risk of infection increase in assisted births?

The use of forceps and lollipops at birth can increase the risk of infection by introducing microbes into the genital tract. Assisted work is usually longer, vaginal examinations, urinary catheterization, pain and surgeries more frequently than natural and spontaneous childbirth. These factors can all increase the risk of infection, which in rare cases can even lead to life-threatening sepsis, say the researchers. In industrialized countries, about one in 20 maternal deaths is due to infection. Seventy other women develop infections serious enough to cause long-term health problems for each life-threatening infection.

How did the preventive antibiotic treatment work?

Between March 2016 and June 2018, participating women received at random either an antibiotic (amoxicillin and clavulanic acid) or a saline placebo administered intravenously within six hours of birth. One-third of births involved a suction cup and two-thirds used special tweezers. In the placebo group, 19% of women had an infection shortly after birth, compared with 11% in the antibiotic group. More severe cases of sepsis confirmed by a positive blood test occurred in 1.5% of the placebo mothers. In women treated with antibiotics, only 0.6% experienced sepsis. The high proportion of infected women was surprising. Most of them were not serious infections that could be life-threatening, but they needed to be treated to prevent serious, life-threatening infections, the researchers explained.

The treatment reduces the total consumption of antibiotics

The protection of women against infection immediately after delivery has also reduced the overall consumption of antibiotics. For 100 doses of prophylactic antibiotics, postpartum physicians were to administer 168 fewer doses. According to the study, the lower incidence of antibiotic infections among women had a positive effect on overall recovery after childbirth. Women taking antibiotics were less often treated for broken sutures and perineal pain than the placebo group. These women also needed fewer home visits or outpatient visits because of their injuries. It is common to administer a single dose of antibiotic to all women requiring cesarean section to reduce the infection. This should also be considered for women after assisted birth, the researchers report. Routine administration of a single dose of antibiotic after assisted delivery can help reduce infections and the cost of healthcare-related complications. (As)

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