From the four small trials evaluated on the prevention of infection, there are insufficient
data for any reliable conclusions to be drawn about the relative benefits and risks of such
prophylactic interventions, including the timing of the intervention. The maximum number
of trials in any of the comparisons was two and none of the trials evaluated was multicentred.
For women experiencing a vaginal delivery, a single dose of postnatal amoxicillinclavulanate
(1.2 gm IV) given one hour after delivery may decrease endometritis, but more
data are needed before this practice can be recommended. The panel therefore decided
not to make any recommendation regarding routine antibiotic prophylaxis following
uncomplicated vaginal delivery for the prevention of puerperal sepsis.
Based on accepted infection prevention principles and practices, the panel agreed that
women should be counselled on hygiene in the postnatal period, especially hand hygiene.
For women who had sustained third or fourth degree perineal tears, the panel noted
benefit in giving prophylactic antibiotics for prevention of perineal wound complications
and therefore recommended antibiotic use for this specific indication