Caesarean: antibiotic prophylaxis: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Caesarean: antibiotic prophylaxis

Sample item

A woman is scheduled for an elective caesarean section. When should intravenous cefazolin 2 g be given to reduce surgical site infection?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Within 60 minutes before skin incision

Prophylactic antibiotics given before incision, usually cefazolin 2 g IV within 60 minutes before the skin incision, are more effective at reducing post-caesarean endometritis and wound infection than after cord clamping and are not shown to harm the neonate. In labour or with ruptured membranes, adding azithromycin 500 mg IV is advised. Higher doses are used in women above 120 kg.

Option by option

  • A. Within 60 minutes before skin incision (correct)

    Correct. Pre-incision dosing within 60 minutes gives tissue levels at the time of surgery.

  • B. At the end of surgery

    Giving the dose at the end of surgery misses the contamination period.

  • C. After cord clamping only

    Administration only after cord clamping is the older practice and is less effective.

  • D. The night before surgery orally

    Oral dosing the night before does not provide adequate intraoperative levels.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this OBG question

What is the answer to this OBG question?

The best answer is A, Within 60 minutes before skin incision. Prophylactic antibiotics given before incision, usually cefazolin 2 g IV within 60 minutes before the skin incision, are more effective at reducing post-caesarean endometritis and wound infection than after cord clamping and are not shown to harm the neonate.

Why is "At the end of surgery" not the answer?

Giving the dose at the end of surgery misses the contamination period.

Why is "After cord clamping only" not the answer?

Administration only after cord clamping is the older practice and is less effective.

Why is "The night before surgery orally" not the answer?

Oral dosing the night before does not provide adequate intraoperative levels.

What concept does this question test?

It tests Caesarean: antibiotic prophylaxis in OBG. In labour or with ruptured membranes, adding azithromycin 500 mg IV is advised. Higher doses are used in women above 120 kg.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Caesarean: antibiotic prophylaxis?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.