Results Prophylactic antibiotics  prevent inflammatory complications after gynaecological surgery .
Prophylactic antibiotics are more effective in surgery requiring access to the peritoneal cavity or the vagina .
Cefotetan appears to be more capable in preventing the overall inflammatory complication rate than cefoxitin or cefazolin .
No benefit has been shown for the combination of antibiotics as prophylaxis .
No difference has been shown between the long-term and short-term use of antibiotics .
There is no need for the primary use of an anaerobic antibacterial agent .
Conclusion Antibiotics help to prevent postoperative inflammatory complications after major gynecologic surgeries
Purpose The aim of this study was to systematic ally review the literature on antibiotic prophylaxis in gynaecologic surgeries to prevent inflammatory complications after gynaecological operations .
Prophylaxis in gynaecological and obstetric surgery: a comparative randomised multicentre study of single-dose cefotetan versus two doses of cefazolin.
Antimicrobial prophylaxis is recommended in all clean-contaminated surgery where the critical threshold of number and virulence of the contaminating organisms with respect to host resistance is reached . Obstetric and gynaecological surgery is clean-contaminated and risk of infection due to aerobic and anaerobic bacteria without prophylaxis can be quantified at 30 - 40 % for vaginal hysterectomy , 10 - 35 % for abdominal hysterectomy and 10 - 34 % for caesarean section . To assess the role of two different cephalosporins as short term prophylaxis , we carried out a multicentre r and omised study involving a single 2 g i.v . dose of cefotetan in comparison with two doses of cefazolin ( 2 g i.v . before surgery and after 8 hours ) . Criteria for exclusion were : exposure to antibiotics within 7 days , preoperative infection , hypersensitivity to beta-lactams . Four hundred and sixty patients entered the study , of which 229 received  cefotetan and 231 cefazolin . No significant differences in mean age , obesity , preoperative weight loss , diabetes , type of disease , type of surgery ( vaginal or abdominal hysterectomies and caesarean sections ) and number of pregnancies and abortions existed between the two groups of patients . The total rate of infected patients undergoing hysterectomy  was 8.6 % ( 13/151 ) in the cefotetan group and 17.4 % ( 29/167 ) in the cefazolin group ( p less than 0.05 ) . This difference was due to cases of symptomatic bacteriuria and antibiotic retreatment , while wound infections were not significantly different ( 2.6 % and 1.8 % respectively ) . Among patients undergoing caesarean section , 9 of 78 ( 11.5 % ) and 7 of 64 ( 10.9 % ) were infected following cefotetan and cefazolin , respectively ( not significant ) . Cefotetan mean tissue concentrations in gynaecological organs were higher than those of cefazolin ( 25.5 - 44.8 vs. 7.4 - 9.5 mg/kg ) . ( ABSTRACT TRUNCATED AT 250 WORDS
Results Prophylactic antibiotics  prevent inflammatory complications after gynaecological surgery .
Prophylactic antibiotics are more effective in surgery requiring access to the peritoneal cavity or the vagina .
Cefotetan appears to be more capable in preventing the overall inflammatory complication rate than cefoxitin or cefazolin .
No benefit has been shown for the combination of antibiotics as prophylaxis .
No difference has been shown between the long-term and short-term use of antibiotics .
There is no need for the primary use of an anaerobic antibacterial agent .
Conclusion Antibiotics help to prevent postoperative inflammatory complications after major gynecologic surgeries
Purpose The aim of this study was to systematic ally review the literature on antibiotic prophylaxis in gynaecologic surgeries to prevent inflammatory complications after gynaecological operations .