From September 2014 to January 2016, women who undergo elective and non-elective caesarean section in Alzahra hospital will be studied. Exclusion criteria are immune deficiency; renal failure; women with two out of four SIRS (systemic inflammatory response syndrome) criteria [ 1)body temperature above 38 or below 36 degree 2)pulse rate above 90 per minute 3)respiratory rate above 20 per minute 4)WBC above 12000 or below 4000]; hypersensitivity to cefazolin or azithromycin; patient who have received antibiotics in the past three months; diabetics. For enrolling patient in group A, cefazolin, or group B, cefazolin plus azithromicin, we will use random table number and blocked randomization. Patient in group A will receive a single dose IV 1g cefazolin after clamping umbilical cord. In group B, they will receive the same IV 1g cefazolin, plus 2 pills of azithromicin (250mg) from Keyhandaroo Company, Iran made, when they are able to intake by mouth.
After selecting patient, they will receive complete information about the study and the method by
attending physician or resident. If they accept to check the informed consent they will enter the study. After that, the study checklist about demographic information, obstetrics and gynecology, present pregnancy, past history of wound infection will be completed. Routine clinical information like pre intra and post-operative vital signs will be recorded to the time of discharge. Also the operative field will be checked for infection. The patients are requested to come back 10 days and one month later for follow up. In this study we will evaluate the incidence of cesarean site wound infection, endometritis and other infections, duration of hospitalization, and cost.