Antibiotic Prophylaxis with Episiotomy—Is it Necessary?
Ab s t r Ac t Background: A hospital-based prospective randomized controlled trial was conducted at a tertiary care hospital. The aim of the study is to determine if a single dose of intravenous antibiotic was superior to a course of oral antibiotics post-episiotomy or no antibiotics at all. Materials and methods: A total of 300 cases undergoing normal vaginal delivery with episiotomy were included in this study and were randomly divided into three groups. Group A received a single prophylactic injectable dose during episiotomy, group B received oral antibiotics for 3 days after the delivery, and group C received no antibiotics. The groups were compared per day 3 total leukocyte count (TLC), presence of foul-smelling lochia, episiotomy gaping, and mean redness, edema, ecchymosis, discharge, approximation (REEDA) score at the time of discharge. Results: The mean age of the study group was 25.09 years with no difference between the study groups (p = 0.356). No difference was seen among IV antibiotic, oral antibiotic, and no antibiotic groups with respect to the mean total leukocyte count on the third postoperative day (p = 0.69). The prevalence of episiotomy gaping was seen in 2%, 3%, and 1% cases among IV antibiotic, oral antibiotic, and no antibiotic groups, respectively (p = 0.60). The mean REEDA score in subjects of IV antibiotic, oral antibiotic, and no antibiotic groups was 3.91, 4.11, and 4.04, respectively (p = 0.49). None of the patients in any of the groups showed long-term complications like keloid. Conclusion: The present study showed that there is no additional benefit of prophylactic antibiotics, given before or after episiotomy.