Wound infections and systemic antibiotic prophylaxis in gynecologic surgery. A review.
The gynecologic literature was reviewed and yielded 11 well-designed and well-conducted studies since 1960 involving the use of systemic prophylactic antibiotics. Five had significant results that support using prophylactic antibiotics in vaginal hysterectomy while three supported prophylaxis in cesarean sections. A cephalosporin agent is effective as a prophylactic agent and should be administered 2 hours before surgery by the intravenous route and discontinued 24-72 hours after surgery. A change in the bacteriologic flora of the cervical cuff occurs after surgery with an increase in E. coli and enterococci and a decrease in coagulose negative staphylococci and steptococci. Future studies should be randomized, prospective, and performed in a double-blind manner with antibiotics begun preoperatively. Special attention should be given to bacteriologic techniques, especially the search for anaerobic pathogens.
D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001431:Bacteriological Techniques; D001439:Bacteroides / Q000187:drug effects; D002511:Cephalosporins / Q000008:administration & dosage / Q000627:therapeutic use; D002584:Cervix Uteri / Q000382:microbiology; D002585:Cesarean Section; D004716:Endometritis / Q000209:etiology / Q000517:prevention & control; D004926:Escherichia coli / Q000187:drug effects; D005260:Female; D005831:Genital Diseases, Female / Q000601:surgery; D006801:Humans; D007044:Hysterectomy; D007045:Hysterectomy, Vaginal; D007263:Infusions, Parenteral; D013210:Staphylococcus / Q000187:drug effects; D013530:Surgical Wound Infection / Q000209:etiology / Q000517:prevention & control*; D013997:Time Factors
D000900:Anti-Bacterial Agents; D002511:Cephalosporins