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Giving antibiotics to ladies inside 24 hours of an obstetric tear throughout childbirth is related to a decreased danger of bigger/clinically related wound issues, discover the outcomes of a medical trial from Denmark revealed by The BMJ at present.
The researchers say this discovering helps the usage of preventive (prophylactic) antibiotics after a second diploma tear or episiotomy, which impacts hundreds of thousands of ladies annually throughout the globe.
However extra analysis is required to find out which sufferers are most liable to “clinically relevant” wound infections and can subsequently profit probably the most.
Prophylactic antibiotics are really useful after instrumental deliveries (e.g., when vacuum or forceps are used) as proof suggests they might cut back an infection, however little is understood about their impact in sufferers with obstetric tears after any sort of vaginal supply.
To deal with this, the researchers recognized 442 ladies aged 18 or over with episiotomies or second diploma tears after a vaginal supply at a Copenhagen hospital between March and December 2023.
Members have been randomly assigned to obtain both three doses of oral antibiotics (remedy group) or placebo (management group) beginning inside six hours of supply (postpartum) and repeated at eight hour intervals. They have been assessed 4 to 14 days later.
End result measures have been wound issues, together with separation of a surgically closed wound (dehiscence) and an infection, and clinically related wound issues, outlined as these requiring additional medical care.
The researchers discovered no vital distinction in total wound issues between the 2 teams (22% for antibiotics vs. 29% for placebo).
Nonetheless, clinically related wound issues have been considerably decreased (9% for antibiotics vs. 17% for placebo) and this protecting impact was additionally vital in sufferers at low danger of wound issues.
The researchers estimate that for each 12 ladies given antibiotics, one clinically related wound complication can be prevented. The remedy group additionally obtained fewer extra antibiotics and reported higher well-being. No critical adversarial reactions occurred.
The authors acknowledge some trial limitations and level out that the findings could not apply to different settings or populations, however they are saying key strengths embody a low drop-out fee and brief timeframe, lowering the danger of change in medical follow.
As such, they conclude, “Although no significant effect was seen for overall wound complications, prophylactic antibiotics significantly reduced the risk of clinically relevant wound complications in women with episiotomies and second degree tears.”
“This finding supports the use of prophylactic antibiotics in routine clinical practice after a second degree tear or episiotomy.”
Extra data:
Threat of an infection and wound dehiscence after use of prophylactic antibiotics in episiotomy or second diploma tear (REPAIR examine): single centre, double blind, placebo managed randomised trial, The BMJ (2025). DOI: 10.1136/bmj-2025-084312
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British Medical Journal
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Antibiotics linked to decrease danger of issues after obstetric tear (2025, October 29)
retrieved 29 October 2025
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