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. 2014 Oct 28;2014(10):CD007482. doi: 10.1002/14651858.CD007482.pub3

Bilgin 1998.

Methods Quasi‐RCT; 5 parallel groups.
Unit of randomization: individual.
Participants Dates of data collection: not reported.
Setting: Bursa, Turkey.
Inclusion criteria: women undergoing CS due to acute fetal distress. N = 119.
Interventions Intervention 1:

  • ceftriaxone 1 g;

  • N = 25.


Intervention 2:

  • mezlocillin 2 g;

  • N = 23.


Intervention 3:

  • clindamycin 600 mg and amikacin 500 mg;

  • N = 18.


Intervention 4:

  • sulbactam ampicillin 1 g (ampicillin + sulbactam);

  • N = 25.


Comparison:

  • no treatment;

  • N = 28.


IV after clamping of the cord.
No treatment comparison was divided: 7 for each of the 4 groups (28/4).
Outcomes Wound infection (redness, tenderness, pain and purulent discharge); UTI (renal angle tenderness, fever, dysuria and pyuria); endometritis (vaginal spotting, purulent discharge with fever and pain) plus positive cultures.
Notes All wound infections were positive for coagulase negative staphylococcus.
Class of antibiotic: 3rd generation cephalosporin vs extended spectrum penicillin (ureidopenicillin) vs aminoglycoside containing combination (lincosamide (clindamycin) and aminoglycoside) vs beta‐lactamase inhibitor combination.
Subgroups:

  • type of CS unclear;

  • after cord clamping.


The 5 groups were comparable regarding maternal age, ruptured membranes, pelvic examinations, hemoglobin levels.
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) High risk Quote: "...according to the last digital of the patient's file number...".
Comment: Quasi‐RCT.
Allocation concealment (selection bias) Unclear risk Comment: no information provided.
Incomplete outcome data (attrition bias) 
 All outcomes Low risk Comment: no losses or exclusions were reported; it appeared to be an ITT analysis.
Selective reporting (reporting bias) Unclear risk Comment: insufficient information to judge.
Blinding of participants and personnel (performance bias) 
 All outcomes High risk Comment: no blinding, not placebo‐controlled.
Blinding of outcome assessment (detection bias) 
 All outcomes High risk Comment: probably outcome assessment was not blinded.
Other bias Low risk Comment: no other sources of bias identified.