Introduction: The aim of this study was to compare the incidence of puerperal infection in patients who received systematic postpartum antibiotic prophylaxis with those who did not. 
Methods: We conducted a quasi-experimental, uncontrolled, before-and-after study at the maternity unit of Hôpital Principal de Dakar, with a retrospective arm (1 March to 31 May 2023) and a prospective arm (1 March to 31 May 2024). Term patients who delivered vaginally or by caesarean section without identifiable infection risk factors at delivery were included. The "before" cohort (T, 2023) had received systematic postpartum antibiotic prophylaxis, whereas the "after" cohort (C, 2024) had not, apart from peri-operative prophylaxis at caesarean section. Puerperal infection was defined using standardized CDC/NHSN criteria for surgical site infection and clinical criteria for endometritis, and was ascertained at day 3 and day 7 postpartum in both cohorts. Data were analyzed with R version 4.3.3 using descriptive and univariate analyses, with the significance threshold set at α = 5%. 
Results: A total of 442 patients were included (183 in 2023 and 259 in 2024). No puerperal infection was observed after vaginal delivery in either cohort. Among caesarean deliveries, seven puerperal infections were recorded in 2024 versus none in 2023; we did not detect a statistically significant difference between the two periods (p = 0.064). Given the very small number of events, this result should not be interpreted as evidence of equivalence between the two strategies. 
Conclusion: Discontinuation of systematic postpartum antibiotic prophylaxis after vaginal delivery was not associated with a detectable increase in puerperal infection in our series, although the study was underpowered to exclude a clinically meaningful difference. These findings require confirmation in a larger, fully prospective cohort before any change in practice can be recommended.