Methods	RCT; 2 parallel groups.
	Unit of randomization: individual.
Participants	Dates of data collection: February to July 1991.
	Setting: Sousse Hospital, Tunisia.
	Inclusion criteria: women undergoing elective CS or labor < 12 hours (categorized as ”both“ for this review”
	Exclusion criteria: diagnosed amniotic infection; pyrexia >38°C; antibiotics within 3 days; allergy to beta lactam antibiotics; cardiac disease; diabetes
Interventions	Cephapirine 1 g IV with induction of anesthesia and 6 hours after operation, gentamycin 80 mg IM with induction, metronidazole 500 mg IV with induction (N = 133), vs no treatment (N = 136)
Outcomes	Endometritis; wound infection; pyrexia only (> 38°C 48 hours after surgery): antibiotic 4/133 vs control 9/136; septicemia (0/133 vs 3/136, included as serious morbidity); duration of hospital stay (antibiotic 5.36 days vs control 6.21, P = 0.03, variance not given)
Notes	Follow up at 30 days (86%).
	Translated from French.
	Class of antibiotic: first generation cephalosporin, aminoglycoside and nitroimidazole (metronidazole)
	Subgroups:
	both elective and non-elective CS - not able to separate the data by type of CS; before cord clamping.
Risk of bias
Item	Authors’ judgement	Description
Adequate sequence generation?	Unclear	Allocation “by chance”.
Allocation concealment?	Unclear	Using random number table, patients allocated to treatment if the number is even, no treatment if the number is odd
Blinding?	No	Not placebo controlled.
All outcomes
Incomplete outcome data addressed?	Unclear	No losses or exclusions reported. It appears to be ITT analysis
All outcomes
Free of selective reporting?	Unclear	Insufficient information to judge.
Free of other bias?	Unclear	The groups were similar for age, parity, duration of labor and other risk factors. There was insufficient other information to judge
Overall low risk of bias?	Unclear	Overall unclear.