Antibiotic Prophylaxis Practices for Caesarean Section in Ogun State, Nigeria: A Cross-sectional Study

Abstract

Background: Caesarean section (CS) is a common surgical procedure in obstetrics, but it is associated with increased risk of postoperative infections. Antibiotic prophylaxis has been proven to significantly reduce maternal morbidity and mortality when appropriately administered. The goal of antibiotic prophylaxis is to reduce the intraoperative microbial load to such a level as to enable host innate and adaptive immunity to prevent post-operative infections. Aims: The present study determines the types and combinations of antibiotics most frequently prescribed; assess the level of adherence to international guidelines on antibiotic prophylaxis during CS; and identify the underlying reasons for deviations from evidence-based protocols. Study Design:  Cross-sectional Study. Duration of Study: May 2025 – July 2025. Methodology: This descriptive cross-sectional study assessed the practice of antibiotic prophylaxis in CS among 106 doctors in Ogun State, Nigeria. Data were collected via structured self-administered questionnaires. Results: The majority (96.2%) of respondents routinely prescribed antibiotics for CS, with ceftriaxone being the most commonly used (61.3%). More than half (50.9%) administered antibiotics just before skin incision, while only 30.2% complied with the WHO-recommended timing (within 60 minutes before incision). Almost half (49.1%) routinely continued prophylaxis for 48 hours. Although 55.7% were aware of WHO guidelines, only 17.9% always adhered to them. Barriers to appropriate practice included lack of local hospital protocols, resistance to change, limited availability of recommended antibiotics, and doubts about drug potency. Conclusion: The study highlights gaps between international guidelines and local practice, underscoring the urgent need for policy updates, institutional protocols, and continuous training to promote evidence-based antimicrobial stewardship in CS.