Randomised clinical trial of perioperative cefazolin in preventing infection after hysterectomy.
To determine the efficacy of perioperative cefazolin in preventing pelvic and wound infections after elective non-radical hysterectomy, a randomised, placebo-controlled, double-blind clinical trial was done. Among 86 patients undergoing vaginal hysterectomy, those who received three perioperative 1 g doses of cefazolin (44) had significantly fewer pelvic infections (21% vs. 2%); less standard febrile morbidity (31% vs. 14%); shorter length of stay (LOS); and fewer courses of antibiotics postoperatively. There was no reduction in rate of urinary-tract infection (UTI) (21% vs. 23%). Among 429 women having abdominal hysterectomy, the 206 who received cefazolin had significantly lower rates of wound and pelvic infections (21% vs. 14%), UTI (21% vs. 9%), and febrile morbidity (20% vs. 14%). They also had shorter LOS and received fewer courses of antibiotics postoperatively. Use of perioperative cefazolin was not accompanied by more side-effects. Three doses of perioperative cefazolin seem to be safe, efficacious, and cost-effective in preventing infection after vaginal or abdominal hysterectomy.
D000328:Adult; D000368:Aged; D002437:Cefazolin / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects* / Q000379:methods; D007045:Hysterectomy, Vaginal / Q000009:adverse effects; D017053:Infection Control; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D012306:Risk; D013530:Surgical Wound Infection / Q000517:prevention & control*
D002437:Cefazolin