Single-dose prophylaxis in patients undergoing vaginal hysterectomy: Cefamandole versus cefotaxime

  • The Multicenter Study Group
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      The efficacy of perioperative antimicrobial prophylaxis in preventing infection after vaginal hysterectomy has been demonstrated. In this study 260 patients undergoing vaginal hysterectomy were randomly assigned at five centers to receive 1 gm of cefamandole (N = 129) or cefotaxime (N = 131) immediately before operation. The two treatment groups were comparable. Febrile morbidity occurred in seven (5.4%) cefamandole patients and in 17 (13%) of those given cefotaxime (p = 0.04). In contrast, the number of patients who developed major pelvic infection was equal (cefamandole, 6; cefotaxime, 5). There was no significant difference in the concentration of either drug in the serum or tissues surveyed, and there was no correlation between infection and concentration of antibiotic in either group. The mean hospital stay and the mean total hospitalization charge did not differ significantly between the two groups. Both of these agents given as a single dose before vaginal hysterectomy are effective in reducing postoperative infections. (Am J Obstet Gynecol 1989;160:1198-201.)

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      1. Hysterectomy in women aged 15-44, United States, 197078 [Editorial].
        MMWR. 1981; 30: 173
        • Duff P
        • Park RC
        Antibiotic prophylaxis in vaginal hysterectomy: a review.
        Obstet Gynecol. 1980; 55: 1938
        • Benson WL
        • Brown RL
        • Schmidt PM
        Comparison of short and long courses of ampicillin for vaginal hysterectomy.
        J Reprod Med. 1985; 30: 874
        • Hemsell DL
        • Cunningham FG
        • Kappus S
        • Nobles B
        Cefoxitin for prophylaxis in premenopausal women undergoing vaginal hysterrectomy.
        Obstet Gynecol. 1980; 56: 629
        • Hemsell DL
        • Bawdon RE
        • Hemsell PG
        • Nobles BJ
        • Johnson ER
        • Heard MC
        Single-dose cephalosporin for prevention of major pelvic infection after vaginal hysterectomy: cefazolin versus cefoxitin versus cefotaxime.
        Amt J OBSTET GYNECOL. 1987; 156: 1201
        • Duff P
        • Keiser JF
        • Strong SL
        A comparative study of two antibiotic regimens for the treatment of operative site infections.
        Amt J OBSTET GYNECOL. 1982; 142: 996
        • Hemsell DL
        Hysterectomy prophylaxis-when and how much?.
        Contemp Ob/Gyn. 1985; 26: 124
        • Roberts JM
        • Homesley HD
        Low-dose carbenicillin prophylaxis for vaginal and abdominal hysterectomy.
        Obstet Gynecol. 1978; 52: 83
        • Vincelette J
        • Finkelstein F
        • Aoki FY
        • et al.
        Double-blind trial of perioperative intravenous metronidazole prophylaxis for abdominal and vaginal hysterectomy.
        Surgery. 1983; 93: 185