Remarks

• This recommendation has been integrated from the 2015 WHO recommendations for prevention and treatment of maternal peripartum infections (82), where it was considered a strong recommendation based on very low-certainty evidence.
• The following remarks were made by the Guideline Development Group (GDG) responsible for the original recommendation.
• The GDG was concerned about the potential public health implications of the high rate of routine use of antibiotics following vaginal birth without any specific risk factors in some settings. The group places emphasis on the negative impact of such routine use on the global efforts to contain antimicrobial resistance and, therefore, made a strong recommendation against routine antibiotic prophylaxis.
• In this context, “uncomplicated vaginal birth” refers to vaginal birth in the absence of any specific risk factor for, or clinical signs of, maternal peripartum infection.
• Careful monitoring of all women after birth is essential to promptly identify any sign of endometritis and institute appropriate antibiotic treatment.
• Recommendations on antibiotic use for common intrapartum conditions or interventions that often raise concerns about increased risk of infection are available in the original WHO guideline (82).