[Effectiveness of perioperative preventive use of antibiotics with metronidazole or doxycycline in vaginal hysterectomy].
To prove the effectiveness of perioperative antibiotics prophylaxis (PABP) in prevention of postoperative infections after vaginal hysterectomy the efficacy of rectale Metronidazole application (5 times 500 mg; n = 192) was compared with that of Doxycyclin (2 times 200 mg intravenously; n = 116). The infectious morbidity after both prophylactic antibiotic regimes was compared to that of an untreated group (n = 186). In spite of additionally colporrhapies the feverish standard morbidity without prophylaxis was 13.4%, after Metronidazole application 13.5% and after Doxycyclin 2.6% (p less than 0.05). Simultaneously the rate of necessary antibiotic treatment decreased significantly. Pelvic infections complicated 16.7% of vaginal hysterectomies having no prophylaxis, but only 4.3% after Doxycyclin medication (p less than 0.05). Postoperative urinary tract infections (UTI)--mostly asymptomatic bacteriuria--were not influenced by any PABP. Whereas UTI after bladder catheter duration shorter than two days occurred in 26.0% (without PABP), 29.9% (Metronidazole) respectively 18.2% (Doxycyclin; p greater than 0.05), the rates after a longer stay were 69.6%, 76.8% and 65.7%. It is concluded, that the febrile standard morbidity and pelvic infections were reduced as well as the rate of necessary antibiotics therapies by a prophylactic application of Doxycyclin, but not with Metronidazole. The incidence of postoperative UTI was not reduced by prophylaxis.
Gerber
B
B
Klinik für Gynäkologie und Geburtshilfe, Bereichs Medizin der Wilhelm-Pieck-Universität Rostock.
Wilken
H
H
D000285:Administration, Rectal; D001437:Bacteriuria / Q000517:prevention & control; D004318:Doxycycline / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007045:Hysterectomy, Vaginal; D007262:Infusions, Intravenous; D008795:Metronidazole / Q000008:administration & dosage*; D011292:Premedication; D013530:Surgical Wound Infection / Q000517:prevention & control*
D008795:Metronidazole; D004318:Doxycycline
Effektivität der perioperativen Antibiotikaprophylaxe mit Metronidazol oder Doxycyclin bei der vaginalen Hysterektomie.