Antibiotic prophylaxis against XXXX after normal delivery--is it necessary?

@entity1 @entity6331 @entity137 @entity20395 @entity884
During the years 1959 to 1978 inclusive 2165 @entity1 with @entity6331 had vaginal deliveries at three large Dublin maternity hospitals. There were two (0.09%) cases of puerperal @entity884 , neither of which was unequivocally related to preceding childbirth during this period. Routine peripartum antibiotic prophylaxis was not given to either. A questionnaire of the practice of 19 obstetricians in Ireland showed that 12 (63%) gave antibiotics routinely during labour and after delivery in cardiac @entity1 , five (26%) did not, and two (11%) used them occasionally. Peripheral vein blood was drawn serially from 0 to 30 minutes after vaginal delivery to determine the incidence of asymptomatic @entity20395 . A total of 299 cultures was obtained from 83 normal @entity1 and single blood cultures were positive in three @entity1 (3.6% of @entity1 , 1.0% of cultures). A review of the published reports showed that well-documented cases of @entity884 and of asymptomatic @entity20395 after normal vaginal delivery are uncommon. There is evidence that antibiotic prophylaxis may increase the risk of developing antibiotic-resistant @entity884 . Recommended prophylactic regimens carry a considerable risk of @entity137 . These facts, coupled with a lack of direct evidence in support of the efficacy of antibiotic prophylaxis, suggest that routine peripartum antibiotic prophylaxis is not indicated.
