The Trials of Antibiotic Prophylaxis at Chelsea Hospital for Women

Abstract

SummaryThe Efficacy of prophylaxis in abdominal hysterectomy has been much studied but remains controversial. Recently, there have been some detailed literature reviews on the topic (Berger et al., 1980; Hirschmann and Inui, 1980; Polk, 1981). By evaluating studies which have been carried out scientifically as suggested by Gifford and Feinstein (1969), that is, prospective, double-blind, placebo-controlled and randomised, the authors of these reviews report a reduction in the incidence of complications resulting from infection in nearly all the studies. Particularly with respect to the in, incidence of postoperative wound infection, this reduction is statistically significant in some reports. During the period of January 1982 to March 1983, we assessed the efficacy of prophylaxis, using ampicillin plus penicillanic acid sulphone (Sulbactam sodium CP 45899, Pfizer) or ampicillin plus metronidazole, in major gynaecological surgery carried out at our hospital (Study A; Houang er al., 1984). The results obtained in patients undergoing abdominal hysterectomy will be reported here. Since November 1983, we have been studying the efficacy of piperacillin in prophylaxis for abdominal hysterectomy in comparison with the combination of ampicillin plus metronidazole (Study B). We also report the preliminary results of this study.