Methods	RCT; 2 parallel groups.
Participants	Dates of data collection:Not specified.
	Setting: Fairfax Hospital, Virginia, US. Women predominantly private
	Inclusion: criteria: high-risk women undergoing CS (in active labor and/or ruptured membranes > 4 hours); not consistent with the criteria for non-elective in this review:
	classified as “both/undefined” in this review Exclusion: active infection, fever, antibiotic use within 3 days, allergy to penicillin or cephalosporins
Interventions	Ceftizoxime 2 g (N = 50) vs placebo (N = 49) IV at time of cord clamping
Outcomes	Febrile morbidity (oral temperature > 37.9°C twice at least 8 hr apart, after first 24 hr); endometritis (fever and foul lochia or uterine tenderness); UTI (fever and positive culture); wound infection (fever, abnormal-looking wound, surrounded by cellulitis and/or draining purulent material)
Notes	Class of antibiotic: third generation cephalosporin.
	There was 1 drug reaction (maculopapular rash) in the treatment group.
	Women followed up at 6 weeks.
	Subgroups: type of CS unclear; after cord clamping.
Risk of bias
Item	Authors’ judgement	Description
Adequate sequence generation?	Unclear	“randomized.” Method not described.
Allocation concealment?	Unclear	No information.
Blinding?	Unclear	Placebo controlled.
All outcomes		Described as “double-blinded” but insufficient information to judge whether there was adequate blinding of study personnel
Incomplete outcome data addressed?	Unclear	No loss of participants to follow up.
All outcomes		1 patient was removed from the study when she became febrile in the delivery room, not included in ITT analysis
Free of selective reporting?	Unclear	Insufficient information to judge.
Free of other bias?	Unclear	“The groups were comparable. No significant differences were observed between the 2 groups with respect to maternal age, parity, gestational age, duration of labor, duration of ruptured membranes or use of internal fetal monitoring. There were no significant differences regarding indication for CS”. There was insufficient other information which to judge
Overall low risk of bias?	Unclear	Mostly unclear.