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Single-dose cephalosporin for prevention of major pelvic infection after vaginal hysterectomy: cefazolin versus cefoxitin versus cefotaxime.

Abstract：

:Antimicrobial overutilization accelerates the development of bacterial resistance. A prospective, randomized, blinded clinical trial of vaginal hysterectomy prophylaxis was designed to compare the efficacy, safety, and costs of cefazolin with those of cefoxitin and cefotaxime. Sixteen women (7.5%) developed febrile morbidity only, 10 (4.7%) developed major pelvic infection requiring parenteral antimicrobial therapy, and neither clinical nor laboratory adverse reactions of significance were observed. Anemia, diabetes, and additional surgical procedures were associated with a significantly increased incidence of postoperative infection; no regimen was more protective for women with or without these risk factors. Infections almost doubled hospital stay and the charges for health care. Diagnosis-related group reimbursement would have been more than $1,300 less than the mean hospital charge for women who developed infection. Utilizing cefazolin for prophylaxis and reserving cefoxitin and cefotaxime for therapy is cost and antimicrobial efficient.

journal_name

Am J Obstet Gynecol

journal_title

American journal of obstetrics and gynecology

authors

Hemsell DL,Bawdon RE,Hemsell PG,Nobles BJ,Johnson ER,Heard MC

doi

10.1016/0002-9378(87)90144-x

subject

Has Abstract

pub_date

1987-05-01 00:00:00

pages

1201-5

issue

5

eissn

0002-9378

issn

1097-6868

pii

0002-9378(87)90144-X

journal_volume

156

pub_type

临床试验,杂志文章,随机对照试验

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