NEW YORK (Reuters Health) – Unless they are already on appropriate antibiotics, all women undergoing cesarean delivery should be given prophylactic antibiotics within an hour before the procedure, according to a Committee Opinion issued by the American College of Obstetricians & Gynecologists

The guidance, “Antimicrobial Prophylaxis for Cesarean Delivery: Timing of Administration,” is published in the September issue of Obstetrics & Gynecology.

The committee notes that antimicrobial prophylaxis is routine for cesarean deliveries, but the timing is debated. The concern has been that onboard antibiotics might mask an infection in the neonate, or perhaps lead to an increase in newborn infections with antibiotic-resistant bacteria. Therefore, prophylactic antibiotics have often been given after cord clamping.

The authors of the report reviewed three recent randomized trials that compared outcomes with different timings of antimicrobial prophylaxis. “From these data, it would appear that preoperatively administered antimicrobial prophylaxis does not appear to have any deleterious effects on mother or neonate,” the report states.

Furthermore, preoperative administration compared to administration after cord clamping significantly reduces endometritis and total maternal infectious morbidity.

Based on surgical research data, the committee recommends that antibiotics be given within an hour before skin incision.

“Anytime you have invasive surgery, you have an increased risk of developing an infection at the incision site,” Dr. William H. Barth, Jr, chair of the Committee on Obstetric Practice, stated in an ACOG press release. “This new recommendation should help reduce the overall rate of cesarean-related infections.”

Obstet Gynecol 2010;116:791–792.