Use Antibiotics at 2nd Degree OB Lac Repair?

From Dr. Chapa’s OBGYN Clinical Pearls Dr. Chapa’s Clinical Pearls

Do you routinely order prophylactic antibiotics at time ofsecond-degree laceration repair? Is there data for that? While the use of prophylacticantibiotics “is reasonable” (per ACOG PB 198) for OASIS lacerations, what doesthe data look like for second degree lacs? Well, the answer is both supportiveAND non-supportive of that practice! In this episode, we will cover a brand newpublication (RCT) from BMJ on this very issue, and also highlight a meta-analysisfrom Plos One (May 2025) that also examined this question. Listen in fordetails!

1. ACOG PB 198

2. Armstrong H, Whitehurst J, Morris RK, HodgettsMorton V, Man R; CHAPTER group. Antibiotic prophylaxis for childbirth-relatedperineal trauma: A systematic review and meta-analysis. PLoS One. 2025 May9;20(5):e0323267. doi: 10.1371/journal.pone.0323267. PMID: 40344566; PMCID:PMC12064200.

3. Risk of infection and wound dehiscence after useof prophylactic antibiotics in episiotomy or second degree tear (REPAIR study):single centre, double blind, placebo controlled randomised trial. BMJ 2025; 391doi: https://doi.org/10.1136/bmj-2025-084312 (Published 29 October 2025): BMJ2025;391:e084312