Low dose prophylactic antibiotics in vaginal hysterectomy.

Abstract

The use of prophylactic antibiotics in elective vaginal hysterectomy with either anterior and/or posterior colporrhaphy was evaluated in a prospective double-blind controlled study. All private patients of 10 gynecologists and all clinic patients undergoing vaginal hysterectomy with either anterior and/or posterior repair at Mercy Hospital and Medical Center San Diego California from December 1970 to June 1972 were included in this study. The patients either received a total of 3 g of cephaloridine or 3 g of an antibiotically inert placebo. 1 g was given intramuscularly (IM) on call to the operating room followed by 1 g IM at 5 and 12 hours after the original dose. When morbidity was defined as a temperature of 100.4 degrees F or greater for 2 days (excluding the first 48 hours) a vaginal cuff abscess or a urinary tract infection the infectious morbidity was 52 percent in the control group and 9 percent in the drug-treated group. Arguments were proposed for a stricter definition of temperature morbidity. Using the above criteria for morbidity but requiring that the temperature be equal to or greater than 101 degrees F for 2 readings at least 4 hours apart (after the first 48 hours) the infectious morbidity was 32 percent in the control group and 8 percent in the drug-treated group. The prophylactic use of low-dose cephaloridine is recommended to decrease postoperative infectious morbidity after vaginal hysterectomy with repair.