C R I T E R I A F O R C O N S I D E

C R I T E R I A F O R C O N S I D E R I N G
S T U D I E S F O R T H I S R E V I EW
Types of studies
All trials were considered where the intention was to allocate participants
randomly to receive antibiotic prophylaxis or no antibiotics
for cesarean section.
Types of participants
Women undergoing cesarean delivery, both elective and non-elective.
Rupture of membranes for more than six hours or the presence
of labour were used to differentiate a non-elective cesarean
delivery from an elective procedure.
Types of intervention
Trialswere considered if they compared any prophylactic antibiotic
regimen administered for cesarean delivery with placebo or no
treatment.
Types of outcome measures
Trials were considered if any one of the following clinical outcomes,
however they were defined by the authors, was reported:
(i) fever;
(ii) wound infection;
(iii) endometritis;
(iv) urinary tract infection;
(v) serious infectious complication (such as bacteremia, septic
shock, septic thrombophlebitis, necrotizing fasciitis, or death attributed
to infection).
In addition, datawere collected (where available) on adverse events
of treatment (eg allergic reactions, antibiotic-associated diarrhea,
development of bacterial resistance), maternal length of stay and
costs, and any infant outcomes reported.
S E A R C H M E T H O D S F O R
I D E N T I F I C A T I O N O F S T U D I E S
See: methods used in reviews.
This review has drawn on the search strategy developed for
the Pregnancy and Childbirth Group as a whole. The full list
of journals and conference proceedings as well as the search
strategies for the electronic databases, which are searched by the
Group on behalf of its reviewers, are described in detail in the
’Search strategies for the identification of studies section’ within
the editorial information about the Cochrane Pregnancy and
Childbirth Group. Briefly, the Group searches on a regular basis
MEDLINE, the Cochrane Controlled Trials Register and reviews
the Contents tables of a further 38 relevant journals received via
ZETOC, an electronic current awareness service.
Relevant trials, which are identified through the Group’s search
strategy, are entered into the Group’s Specialised Register of
Controlled Trials. Please see Review Group’s details for more
detailed information. Date of last search: January 2002.
In addition, the Cochrane Controlled Trials Register (The
Cochrane Library, Issue 4, 2001) was searched on the terms
(ANTIBIOT* or ANTIMICR*) and (CAESAR* or CESAR*).
M E T H O D S O F T H E R E V I EW
All potential trials were selected for eligibility according to the
criteria specified in the protocol and data were extracted from
each publication by two reviewers. Any discrepancieswere resolved
by discussion. In addition to the main outcome measures listed
above, information on the setting of the study (country, type of
population, socioeconomic status), a detailed description of the
antibiotic regimen used (drug, dose, frequency and timing), and
definitions of the outcomes were collected. An intent to treat
analysis was performed where the data were provided to enable
this to be done.
Trials were assessed for methodological quality using the standard
Cochrane criteria of adequacy of allocation concealment: adequate
(A), unclear (B), inadequate (C), or that allocation concealment
was not used (D). Note was made on whether the trials were
placebo controlled and information on blinding of outcome
assessment and loss to follow-up was collected.
The main comparison of any treatment versus no treatment was
stratified bywhether the cesarean section was elective, non-elective
or a combination of both/unspecified, resulting in four main
comparisons:
(1) Any antibiotic versus placebo/no treatment (elective cesarean
deliveries).
(2) Any antibiotic versus placebo/no treatment (non-elective
cesarean deliveries).
(3) Any antibiotic versus placebo/no treatment (a combination of
both elective and non-elective/unspecified cesarean deliveries).
(4) Any antibiotic versus placebo/no treatment (all cesarean
deliveries).
Summary relative risks were calculated using a fixed effects model
where there was no significant heterogeneity among trials (chisquared
test for heterogeneity

Results (Indonesian) 1:

C R SAYA T E R AKU F O R C O N S I D E R I N GS T U D SAYA E S F O R T H I S R E V SAYA EWJenis penelitianSemua percobaan dianggap dimana tujuannya adalah untuk mengalokasikan pesertasecara acak untuk menerima antibiotik prophylaxis atau antibiotik tidakuntuk Caesar.Jenis pesertaWanita yang mengalami persalinan Caesar, elektif maupun non-pilihan.Sindrom selama lebih dari enam jam atau kehadirantenaga kerja yang digunakan untuk membedakan non-pilihan Caesarpengiriman dari prosedur elektif.Jenis intervensiTrialswere dianggap jika mereka dibandingkan antibiotik profilaksis apapunrejimen yang diberikan selama persalinan Caesar dengan plasebo atau tidakpengobatan.Jenis hasil tindakanUji dianggap jika salah satu dari hasil klinis yang berikut,Namun mereka didefinisikan oleh penulis, dilaporkan:(i) demam;(ii) luka infeksi;(iii) endometritis;(iv) infeksi saluran kemih;(v) serius komplikasi infeksi (seperti bacteremia, sepsiskejutan, septik tromboflebitis, necrotizing fasciitis atau kematian yang disebabkan olehinfeksi).Selain itu, datawere dikumpulkan (dimana tersedia) pada efek sampingpengobatan (reaksi alergi misalnya, diare antibiotik yang terkait,Perkembangan resistensi bakteri), ibu lama tinggal danbiaya, dan setiap hasil bayi yang dilaporkan.S E R C H M E T H O D S F O RAKU D E N T I F I C T SAYA O N O F S T U D SAYA E SLihat: metode yang digunakan dalam ulasan tamu.Ulasan ini telah diambil pada strategi Cari dikembangkan untukKehamilan dan persalinan kelompok secara keseluruhan. Daftar lengkapjurnal dan Prosiding konferensi serta pencarianstrategi untuk database elektronik, yang akan dapat dicari olehGrup atas nama para pengulas, dijelaskan secara rinci dalam'Cari strategi untuk mengidentifikasi bagian kajian' dalameditorial informasi tentang kehamilan Cochrane danKelompok melahirkan. Secara singkat, kelompok pencarian secara teraturMEDLINE, Cochrane dikendalikan uji mendaftar dan ulasanTabel Isi 38 lebih relevan jurnal yang diterima melaluiZETOC, saat ini kesadaran Layanan elektronik.Uji yang relevan, yang dikenal pasti melalui kelompok pencarianstrategi, yang dimasukkan ke dalam kelompok khusus Register ofUji coba terkontrol. Silakan Lihat rincian Review Group untuk lebihinformasi rinci. Tanggal terakhir pencarian: Januari 2002.Selain itu, the Cochrane dikendalikan uji Register (Cochrane Library, edisi 4, 2001) adalah dicari istilah(ANTIBIOT * atau ANTIMICR *) dan (CAESAR * atau CESAR *).M E T H O D S O F T H E R E V SAYA EWSemua percobaan yang potensial yang dipilih untuk kelayakan menurutkriteria yang ditetapkan dalam protokol dan data diambil darisetiap publikasi oleh dua pengulas. Setiap discrepancieswere yang diselesaikanoleh diskusi. Selain langkah-langkah utama hasil yang tercantuminformasi di atas, pada pengaturan studi (negara, jenispopulasi, status sosial ekonomi), penjelasan rinci tentangantibiotic regimen used (drug, dose, frequency and timing), anddefinitions of the outcomes were collected. An intent to treatanalysis was performed where the data were provided to enablethis to be done.Trials were assessed for methodological quality using the standardCochrane criteria of adequacy of allocation concealment: adequate(A), unclear (B), inadequate (C), or that allocation concealmentwas not used (D). Note was made on whether the trials wereplacebo controlled and information on blinding of outcomeassessment and loss to follow-up was collected.The main comparison of any treatment versus no treatment wasstratified bywhether the cesarean section was elective, non-electiveor a combination of both/unspecified, resulting in four maincomparisons:(1) Any antibiotic versus placebo/no treatment (elective cesareandeliveries).(2) Any antibiotic versus placebo/no treatment (non-electivecesarean deliveries).(3) Any antibiotic versus placebo/no treatment (a combination ofboth elective and non-elective/unspecified cesarean deliveries).(4) Any antibiotic versus placebo/no treatment (all cesareandeliveries).Summary relative risks were calculated using a fixed effects modelwhere there was no significant heterogeneity among trials (chisquaredtest for heterogeneity <0.05). A random effects modelwas used if statistically significant heterogeneity among trials wasobserved.D E S C R I P T I O N O F S T U D I E SEighty-one trials, that enrolled close to 12,000 women, were identifiedthat met the inclusion criteria for this review. For a detaileddescription of studies, see table of ’Characteristics of included studies’.Of those studies excluded fromthe analysis,mostwere becauseeither no clinical outcomes were reported or the specific outcomes