title: A prospective randomized study comparing amoxycillin/clavulanate with cefuroxime plus metronidazole for perioperative prophylaxis in gynaecological surgery.
abstract: A prospective, randomized, open study was performed in 199 patients at the Leyenburg Hospital comparing amoxycillin/clavulanate (AMX/CL) with cefuroxime plus metronidazole (CR/MN) in the prophylaxis of infection following gynaecological surgery. AMX/CL was given as a single dose of 2200 mg i.v. at the start of the operation. CR/MN, 750/500 mg i.v. was administered 3 times within 24 h, beginning at the start of the operation. The study group consisted of patients undergoing either a vaginal hysterectomy, a vaginal hysterectomy with cysto/rectocele repair or a secondary caesarean section. There were no statistically significant differences in demographic characteristics, duration of surgery or anaesthetic method between the two groups. Postoperatively, 10.6% of patients developed a urinary tract infection, and febrile temperatures were found in 9.0% of patients. There were no statistically significant differences between the two treatment groups. Other complications were found in less than 1% of the study population, equally distributed between the two regimens. In this study there was a low overall percentage of infection after gynaecological surgery. AMX/CL was as effective as CR/MN as a perioperative prophylactic treatment and has the dual advantage of a single dose and lower cost.
authors.affiliation: Department of Obstetrics and Gynaecology, Municipal Hospital Leyenburg, The Hogue, The Netherlands.
authors.forename: M C
authors.initials: MC
authors.lastname: van der Linden
authors.forename: E J
authors.initials: EJ
authors.lastname: van Erp
authors.forename: G J
authors.initials: GJ
authors.lastname: Ruijs
authors.forename: J P
authors.initials: JP
authors.lastname: Holm
mesh_terms: D000328:Adult; D000658:Amoxicillin / Q000008:administration & dosage*; D019980:Amoxicillin-Potassium Clavulanate Combination; D001424:Bacterial Infections / Q000517:prevention & control*; D002444:Cefuroxime / Q000008:administration & dosage*; D002585:Cesarean Section; D002969:Clavulanic Acids / Q000008:administration & dosage*; D004359:Drug Therapy, Combination / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007431:Intraoperative Complications / Q000517:prevention & control*; D008795:Metronidazole / Q000008:administration & dosage*; D008875:Middle Aged; D011183:Postoperative Complications; D011247:Pregnancy; D011446:Prospective Studies
chemical_list: D002969:Clavulanic Acids; D008795:Metronidazole; D019980:Amoxicillin-Potassium Clavulanate Combination; D000658:Amoxicillin; D002444:Cefuroxime