Efficacy and safety of broad spectrum penicillin with or without beta-lactamase inhibitors vs first and second generation cephalosporins as prophylactic antibiotics during cesarean section: a systematic review and meta-analysis

Abstract

This study assessed the efficacy and safety between broad spectrum penicillin (P2) with or without beta-lactamase inhibitors (P2+) versus first and second generation cephalosporins (C1&C2) in the prevention of post-cesarean infections. Relevant randomized controlled trials (RCTs) were searched in English and Chinese databases: nine RCTs were involved. Six trials compared P2+ vs C1&C2, no differences were found between interventions for endometritis, wound infection, urinary tract infection, febrile morbidity and maternal rashes. Four trials compared P2 vs C1&C2, no differences were found between interventions for endometritis, febrile morbidity, wound infection and urinary tract infection. Postoperative hospitalization was longer for women in P2 than C1&C2. Based on these results, P2/P2+ and C1&C2 may have similar efficacy on postoperative infections after cesarean section, there is no data on infant outcomes. PROSPERO Registration Number: CRD42022345721.

Keywords:

• Cesarean section
• cephalosporins
• broad spectrum penicillin
• beta-lactamase inhibitors
• postoperative infection
• meta-analysis

Authors’ contributions

Qianqian Song: project development, data collection, data analysis, manuscript writing. Jingjing Yan: project development, data collection, data analysis. Na Bu: project development, revision of the manuscript. Ying Qian: revision of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

All data in relation to this study are presented in this manuscript.

Additional information

Funding

This work was supported by the Natural Science Foundation of Zhejiang Province (Grant numbers: LQ20H300002).