Prophylactic antibiotics for women undergoing vaginal hysterectomy

Abstract

A triple-blind prospective study of women undergoing vaginal hysterectomy was conducted to compare cefazolin, cephaloridine and no antibiotic, Both cefazolin and cephaloridine were given preoperatively, whereas only cephaloridine was given postoperatively. One gram of cefazolin given intramuscularly on call to the operation room was found to be a safe and effective antibiotic for prophylaxis against febrile morbidity. The proper utilization of prophylactic antibiotics seems to be in the immediate preoperative period. The use of antibiotics after the first day of surgery is unnecessary.

PIP: A triple-blind prospective study of 153 women undergoing vaginal hysterectomy between March 1974-February 1975 at Brooke Army Medical Center, was conducted to compare prophylactic antibiotic treatment with nontreatment. The antibiotics studied included cefazolin and cephaloridine. Treated patients received either 1 gm cefazolin on call to the operating room, 3 gm cephaloridine divided into 1 gm doses on call to the operating room, and 1 gm 12 hours later; or were untreated. Febrile morbidity occurred in 7.7% of patients on cefazolin, 12% on cephaloridine, and in 49% of the controls. The predominant organisms recovered were beta hemolytic Streptococcus, group D, intraoperatively and Escherichia coli, postoperatively. The effective use of preoperative prophylaxis is demonstrated.