Comparing of Cefazolin Plus Azithromycin Versus Cefazolin in Prevention of Febrile Morbidity After Emergency Cesarean Delivery

Cesarean section is the common surgery in world wide. But the complication like febrile morbidity such as surgical site infection, fever, urinary tract infection and endometritis can be occurred even giving the standard antibiotics. Therefore if wider bacterial spectrum coverage antibiotic like azithromycin is added to the standard antimicrobial prophylaxis(1st generation cephalosporin), the incidence of febrile morbidity could be reduced. We will compare the regimen of cefazolin plus azithromycin and standard regimen of cefazolin alone in prevention of febrile morbidity after emergency cesarean section.

Inclusion Criteria:Singleton pregnancy with a gestation of 24 weeks or moreUndergoing non-elective cesarean delivery during labor or rupture of membrane more than 4 hrNo allergy to macrolide such as azithromycin and clindamycinProvide informed consentPartner of participant allows the patient to participate the researchExclusion Criteria:Use of azithromycin within 7 days before enrollmentChorioamnionitis or other infection requiring postpartum antibiotic therapy (except for antibiotics for group B streptococcus)Liver disease (Cirrhosis or AST more than 3 times the upper normal limit)Serum creatinine level of more than 2.0 mg/dL or need dialysisDiarrhea at the time of enrollmentMaternal heart diseaseUse of medication known to prolonged the QT interval