Methods |
Randomized controlled trial. |
Participants |
367 women >= 24 weeks who were undergoing cesarean delivery excluding women with a cephalosporin allergy, age < 18 years, exposure to antibiotics within 7 days, need for emergency surgery. |
Interventions |
1 g cefazolin administered at 15‐60 minutes pre‐incision and normal saline after cord clamp (n = 175) versus normal saline at 15‐60 minutes pre‐incision and 1 g cefazolin after cord clamp (n = 182). They did not specify intravenous treatment, but we included this trial as it was assumed that cefazolin was administered intravenously. |
Outcomes |
Primary: total infectious morbidity. |
Notes |
Abstract and paper; study commenced January 2003. 1 hospital in the United States of America. |
Risk of bias |
Bias |
Authors' judgement |
Support for judgement |
Random sequence generation (selection bias) |
Low risk |
Simple randomization using random number tables. |
Allocation concealment (selection bias) |
Low risk |
Investigational pharmacy staff delivered both antibiotics and placebo. |
Blinding of participants and personnel (performance bias)
All outcomes |
Low risk |
Intraoperative labeled bag given by anesthesia. |
Blinding of outcome assessment (detection bias)
All outcomes |
Unclear risk |
Double‐blind trial but does not describe blinding method. |
Incomplete outcome data (attrition bias)
All outcomes |
Low risk |
The preoperative group lost 3 women and the cord clamp group lost 5 women to attrition. |
Selective reporting (reporting bias) |
Low risk |
Prespecified outcomes stated. |
Other bias |
Low risk |
No other bias evident. |