Method(s): After excluding some infected and non- antibiotics prescriptions cases, a sample (total) of 37,760 patients were enrolled into our study and 113,380 antibiotic prescriptions were analyzed. It includes appropriate use of prescribed antibiotics, which was defined by comparing the antibiotic prophylaxis guideline of Cochrane Collaboration in cesarean section. Moreover, different hospital levels (medical centers, regional hospitals, district hospitals, and local clinics) were examined in the paper.

Results: Among these prescriptions, 63.2% were given intravenously while 58.5% of them were first-generation cephalosporin. We find that the rate of overused antibiotics was 67.6%. The appropriate use rate of prescribed antibiotics was 9.2% by patient number and 3.1% by prescribed frequency respectively. Obstetric clinics had the highest inappropriate use rate of antibiotics compared to other hospital levels (p<0.01) while medical centers had the lowest antibiotic prescribed frequency of all (p<0.01).

Conclusions: The results of this study indicated that inappropriate use of antibiotics was common in Taiwan, requiring physician continued education and aggressive interventions to change the physician critical decision making behavior.

Key words: antibiotic prophylaxis, cesarean section, cost, prophylactic antibiotics