During elective cesarean delivery, antibiotic prophylaxis to reduce endometritis is given within 60 minutes of incision; which agent is usually used?

During elective cesarean delivery, antibiotic prophylaxis to reduce endometritis is given within 60 minutes of incision; which agent is usually used?

• A. Within 60 minutes of incision; cefazolin
• B. Before labor begins; penicillin G
• C. After delivery; ampicillin
• D. Within 24 hours; vancomycin

Answer: (A)

The main idea is that surgical antibiotic prophylaxis for cesarean delivery aims to prevent endometritis by providing adequate antibiotic levels at the time the uterine incision is made. The usual agent is cefazolin, a first‑generation cephalosporin, given within 60 minutes before the incision. This timing ensures the drug reaches effective tissue concentrations right when contamination could occur, reducing infection risk without needing to wait for delivery. Cefazolin is chosen because it covers the skin and uterine flora commonly implicated in postoperative infections (staphylococci, streptococci, and many enteric Gram-negative organisms), is rapidly distributed, safe, and cost-effective. Standard dosing is typically 2 g IV (3 g if BMI is high) and is given preoperatively rather than after delivery or during labor, since prophylaxis needs to be present at incision to prevent contamination. If there is a severe beta-lactam allergy or other specific circumstances, alternatives may be used, but cefazolin remains the first-line choice for routine prophylaxis in elective cesarean deliveries.

The main idea is that surgical antibiotic prophylaxis for cesarean delivery aims to prevent endometritis by providing adequate antibiotic levels at the time the uterine incision is made. The usual agent is cefazolin, a first‑generation cephalosporin, given within 60 minutes before the incision. This timing ensures the drug reaches effective tissue concentrations right when contamination could occur, reducing infection risk without needing to wait for delivery.

Cefazolin is chosen because it covers the skin and uterine flora commonly implicated in postoperative infections (staphylococci, streptococci, and many enteric Gram-negative organisms), is rapidly distributed, safe, and cost-effective. Standard dosing is typically 2 g IV (3 g if BMI is high) and is given preoperatively rather than after delivery or during labor, since prophylaxis needs to be present at incision to prevent contamination.

If there is a severe beta-lactam allergy or other specific circumstances, alternatives may be used, but cefazolin remains the first-line choice for routine prophylaxis in elective cesarean deliveries.