Single-Dose Ampicillin Prophylaxis Does Not Eradicate Enterococcus From the Lower Genital Tract

OBJECTIVES:To determine the carriage rate of enterococcus in the lower genital tract of women having a cesarean delivery and to determine whether a single 2-g intraoperative dose of ampicillin eradicates enterococcus from the lower genital tract. METHODS:Lower genital tract cultures were taken in 84 women who were in labor or had ruptured membranes and who were about to have an indicated cesarean delivery. The subjects were randomized to receive either a single 2-g dose of ampicillin or a cephalosporin as prophylaxis. Cultures were repeated 24 hours postpartum. RESULTS:Enterococcus was isolated preoperatively in 33 subjects (39.3%) and postoperatively in 36 (42.9%). The enterococcus was eradicated in five of 17 women (29.5%) who received ampicillin. CONCLUSION:These results suggest that a single 2-g dose of ampicillin does not eradicate enterococcus from the lower genital tract. (Obstet Gynecol 1993;81:115-7)