Caesarean delivery is one of the leading indications for inpatient antibiotic use in Lao PDR. National guidelines recommend a single intravenous dose of ceftriaxone before incision, but evidence on adherence to this recommendation and the associated costs has been limited.
Researchers reviewed 1,105 medical records from central, provincial and district hospitals. Almost all the women included in the study received antibiotics. The most common regimen, prescribed to 70.9% of women receiving antibiotics, was ceftriaxone for three days followed by cephalexin for five days. No case met all the assessed criteria for antibiotic selection, timing and dosage. Among the 2,438 antibiotic courses recorded, 57.4% were classified in the WHO Access group.
Estimated antibiotic expenditure during the six-month study period was US$9,122.30. If all prescriptions had followed the national guideline, the estimated cost would have been US$991.80, representing a potential saving of US$8,120.50. The findings point to the need for stronger antimicrobial stewardship, routine monitoring of prescribing and further research into whether ceftriaxone remains the most appropriate option in Lao PDR. The study did not assess surgical site infections or readmissions and therefore could not determine whether prolonged antibiotic use affected clinical outcomes. The research was conducted as part of an ICARS-supported project to improve appropriate antimicrobial use among women and young children in Lao PDR.
