Benefits , harms , and costs Guideline implementation should result in a reduction of cost and related harm of administering antibiotics when not required and a reduction of infection and related morbidities when antibiotics have demonstrated a proven benefit .
Abstract Objective To review the evidence and provide recommendations on antibiotic prophylaxis for gynaecologic procedures .
Outcomes Outcomes evaluated include need and effectiveness of antibiotics to prevent infections in gynaecologic procedures .
Does pre- and postoperative metronidazole treatment lower vaginal cuff infection rate after abdominal hysterectomy among women with bacterial vaginosis?
OBJECTIVE : Bacterial vaginosis ( BV ) is a known risk factor for postoperative infection following abdominal hysterectomy . Vaginal bacterial flora scored as intermediate has been shown to have the same risk of postoperative infection as BV . METHODS : Women undergoing total abdominal hysterectomy for benign diseases were open-r and omized according to Zelen to either treatment with metronidazole rectally for at least 4 days or no treatment . At the preoperative gynecological examination a vaginal smear was collected and Gram stained . Women with BV or intermediate flora were merged to one group called abnormal vaginal flora . RESULTS : In total 213 women were r and omized to treatment or no treatment . After exclusion of 71 women , 142 women were eligible for analysis . Among the 59 women diagnosed with abnormal vaginal flora there were no vaginal cuff infections in the treated arm , compared with 27 % in the ' no treatment ' arm ( p < 0.01 ) . Treatment also reduced the vaginal cuff infection rate from 9.5 to 2 % among the 83 women with lactobacilli flora . However , this difference was not statistically significant . Treatment had no effect on the rate of wound infections . Intention-to-treat analysis showed a significant reduction in vaginal cuff infections among women r and omized to treatment . CONCLUSION : Pre- and postoperative treatment for at least 4 days with metronidazole rectally reduces significantly vaginal cuff infection among women with abnormal vaginal flora
Benefits , harms , and costs Guideline implementation should result in a reduction of cost and related harm of administering antibiotics when not required and a reduction of infection and related morbidities when antibiotics have demonstrated a proven benefit .
Abstract Objective To review the evidence and provide recommendations on antibiotic prophylaxis for gynaecologic procedures .
Outcomes Outcomes evaluated include need and effectiveness of antibiotics to prevent infections in gynaecologic procedures .