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General principles for the prevention of any surgical infection includesound surgical technique, skin antisepsis and antimicrobialprophylaxis (Owen 1994). Although antibiotic prophylaxis duringcesarean section has been extensively studied and generally foundto be effective in preventing infection, surveys suggest inconsistentand variable application of recommendations for its use (Pedersen1996; Huskins 2001). Questions remain about the indicationsfor prophylaxis, the choice of drug (whether a broad spectrum orlonger acting agent is better), its route, timing and frequency, thecost-effectiveness of different strategies, adverse effects of antibioticsfor the woman and her infant, and the potential for increaseduse of antimicrobial prophylaxis to be a factor in the developmentantimicrobial resistance (Mugford 1989; Mallaret 1990a; Shlaes1997). Particularly controversial is whether antibiotic treatmentshould be given to all mothers or only to those at greatest risk ofinfection (Gilstrap 1988; Suonio 1989; Ehrenkrans 1990; Howey1990).
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