Two of the studies in high-income countries compared antibiotics with either a placebo or
no antibiotic . Duggal and colleagues in the USA compared a second-generation
cephalosporin (single dose of cefotetan or cefoxitin, 1 g IV in 100 ml saline) with a placebo
given before repair of the perineal tear with the primary aim of prevention of postpartum
perineal wound complications in women who had sustained either a third or fourth degree
tear after normal vaginal delivery. Fernandez and colleagues in France compared
a single dose of amoxicillin-clavulanate (1.2 g) given one hour after delivery versus no
antibiotic as a prophylaxis against postpartum endometritis in women who had delivered
vaginally and were free from infection