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

1. ACOG PB 198

2. Armstrong H, Whitehurst J, Morris RK, Hodgetts Morton V, Man R; CHAPTER group. Antibiotic prophylaxis for childbirth-related perineal trauma: A systematic review and meta-analysis. PLoS One. 2025 May 9;20(5):e0323267. doi: 10.1371/journal.pone.0323267. PMID: 40344566; PMCID: PMC12064200.

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