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 .
Placebo-controlled, double-blind, randomized study of prophylactic antibiotics in elective abdominal hysterectomy.
To assess the efficacy of a single dose of ampicillin or cefazolin in preventing fever and infection after elective abdominal hysterectomy , we conducted a multicentre , r and omized , double-blind , controlled trial at Srinagarind Hospital , Faculty of Medicine , Khon Kaen University and Khon Kaen Regional Hospital . Three hundred and thirty patients scheduled for elective abdominal hysterectomy were r and omly allocated into either placebo , ampicillin or cefazolin groups . Patients received sterile water ( 3 mL ) or ampicillin ( 1 g ) or cefazolin ( 1 g ) intravenously according to r and om assignment 30 min before the operation . After the operation , all patients were assessed by blinded independent evaluators until discharged from the hospitals . Our main outcome measures were postoperative fever and infectious morbidity . We found that 321 patients ( 97.3 % of recruited patients ) were available for data analysis , 108 in placebo , 106 in ampicillin and 107 in cefazolin group . Febrile morbidity occurred in 13/108 ( 12.0 % ) , 14/106 ( 13.2 % ) and 12/107 ( 11.2 % ) of patients in the placebo , ampicillin and cefazolin groups , respectively . There was no statistically significant difference in febrile morbidity between the three groups . Infectious morbidity was found in 29/108 ( 26.9 % ) , 24/106 ( 22.6 % ) and 11/107 ( 10.3 % ) of patients in the placebo , ampicillin and cefazolin groups , respectively . There was a statistically significant difference between the placebo and cefazolin groups ( P = 0.002 ) . Between the placebo and ampicillin groups , the result was not significantly different ( P = 0.476 ) . There was a statistically significant difference between the cefazolin and ampicillin groups ( P = 0.015 ) . The common causes of infectious morbidity were urinary tract infection , vaginal cuff infection and surgical wound infection . We concluded that antibiotic prophylaxis by cefazolin should be recommended for elective total abdominal hysterectomy
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 .