Prophylactic Antibiotics Beneficial for Episiotomy, Second-Degree Tear

TUESDAY, Nov. 4, 2025 (HealthDay News) -- Prophylactic antibiotics do not have a significant effect on overall wound complications but significantly reduce the risk for clinically relevant wound complications in women with episiotomy or second-degree tear, according to a study published online Oct. 29 in The BMJ.Kathrine Perslev, from Herlev University in Denmark, and colleagues conducted a single-center, placebo-controlled randomized trial to examine the effect of prophylactic antibiotics on the risk for wound complications after episiotomy or second-degree tear. The study included 442 women with episiotomies or second-degree tears who were randomly assigned to receive three doses of amoxicillin (500 mg) with clavulanic acid (125 mg) or placebo starting within six hours postpartum and repeated at eight-hour intervals.The primary analysis included 433 women. The researchers found no significant between-group difference in overall wound complications. Significantly fewer events occurred in the treatment group for clinically relevant wound complications (9 versus 17 percent; relative risk, 0.52). The number needed to treat was 12 for clinically relevant wound complications. Better self-evaluated health, fewer additional antibiotic treatments, and smaller average wound dehiscence among patients with dehiscence was seen in the treatment group. There were no serious adverse reactions."This finding supports the use of prophylactic antibiotics in routine clinical practice after a second-degree tear or episiotomy," the authors write.Abstract/Full Text.Sign up for our weekly HealthDay newsletter