Abstract
A randomized double-blind prospective study on the efficacy of single-dose antibiotic prophylaxis compared cefuroxime versus metronidazole versus the combination of both agents in vaginal hysterectomy. Overall antibiotic prophylaxis was effective in abscess prevention (one abscess in 68 patients). In the metronidazole group a significantly higher grade of morbidity was observed: febrile morbidity 41% versus 4% in the two other groups; bacteriuria 73% versus 17% in the cefuroxime group, versus 13% in the combined group; urinary tract infection 23%, versus 0% in the two other groups; post-operative prescription of antibiotics 41%, versus 0% in the two other groups. Febrile morbidity and bacteriuria correlated positively withEscherichia coli andProteus spp. These micro-organisms were recovered significantly more often from the vagina of patients in the metronidazole group. Cefuroxime was successful, metronidazole failed in the prevention of minor morbidity. We could not observe any effect from the addition of metronidazole to the cefuroxime prophylaxis.
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References
Brouwer WK, Kuiper KM, Langbroek W. The efficacy of prophylaxis with cefuroxime and metronidazole in gynaecological surgery. Res Clin Forums 1984;6:25–33.
Leabeater B, Kingston J. Cefuroxime and metronidazole in gynaecological surgery. Br J Obstet Gynaecol 1981;88:543–7.
Wijma J, Kauer FM, Van Saene HKF, Van de Wiel HBM, Janssens J. Antibiotics and suction drainage as prophylaxis in vaginal and abdominal hysterectomy. Obstet Gynecol 1987;70:384–8.
Ledger WJ, Sweet RL, Headington JT. Prophylactic cephaloridine in the prevention of post-operative pelvic infections in premenopausal women undergoing vaginal hysterectomy. Am J Obstet Gynecol 1973;115:766–74.
Hamod KA, Spence MR, Rosenshein NB, Dillon MB. Single-dose and multidose prophylaxis in vaginal hysterectomy: a comparison of sodium cephalothin and metronidazole. Am J Obstet Gynecol 1980;136:976–9.
Heginbotham D, Rutherford AM. Metronidazole in the prophylaxis of anaerobic infections in gynaecological surgery. NZ Med J 1979;89:246–8.
Onderdonk AB, Bartlett JG, Louie T, Sullivan-Seigler N, Gorbach SL. Microbial synergy in experimental intra-abdominal abscess. Infect Immun 1976;13:22–6.
Van Saene HKF, Stoutenbeek CP, Miranda DR, Zandstra DF. A novel approach to infection control in the intensive care unit. Acta Anaesthesiol Belg 1983;34:193–208.
Nissen D, Goldstein AI. A prospective investigation of the etiology of febrile morbidity following abdominal hysterectomy. Am J Obstet Gynecol 1972;113:111–4.
Shapiro M, Munoz A, Tager IB, Schoenbaum SC, Polk BF. Risk factors for infection at the operative site after abdominal or vaginal hysterectomy. N Engl J Med 1982;307:1661–6.
Kass EH. Chemotherapeutic and antibiotic drugs in the management of infections of the urinary tract. Am J Med 1955;18:764–81.
Hamod KA, Spence MR, King TM. Prophylactic antibiotics in vaginal hysterectomy: a review. Obstet Gynaecol Surv 1982;37:207–16.
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Kauer, F.M., Wijma, J. & Manson, W.L. Vaginal hysterectomy: cefuroxime, metronidazole or both?. Pharmaceutisch Weekblad Scientific Edition 12, 284–288 (1990). https://doi.org/10.1007/BF01967834
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DOI: https://doi.org/10.1007/BF01967834