Short course of prophylactic antibiotics in laparoscopically assisted vaginal hysterectomy.
OBJECTIVE
To evaluate whether a short course of prophylactic antibiotics is as efficacious as a longer course in laparoscopically assisted vaginal hysterectomy (LAVH).


METHODS
A total of 156 patients who underwent LAVH were included in the study; 82 received a long course of combined prophylactic antibiotics, and 74 received a short course, administered for < 24 hours during the perioperative period. The subjects were randomly assigned using a computer-generated schedule. Data regarding resource consumption were collected from the hospital's electronic database. Patient characteristics and medical care process data were collected from the patient charts. Student's t test was used to determine the statistical significance of the differences between continuous variables in the 2 groups of patients. The chi2 test was used to measure the statistical significance of differences between nominal variables in the 2 groups.


RESULTS
The short course significantly influenced the number of injected vials of antibiotics, the antibiotic fee and the total admission fee. The average total admission fee decreased by 2.3% (p = 0.034), and the average antibiotic-fee dropped by 68.4% (p < 0.01). The average injected vials of cephalothin decreased by 4.3, and the vials of gentamycin decreased by 3.3 (p < 0.01). As for the rate of operative site infection and urinary tract infection during hospitalization and within 7 days of discharge, no statistical differences were found between the 2 groups (p = 0.735; p = 0.917).


CONCLUSIONS
This pilot study revealed that a short course of prophylactic antibiotics was as efficacious as a longer course in preventing postoperative infection. It was also cost-effective.
Chang
Wei-Chun
WC
Department of Obstetrics and Gynecology and of Family Medicine, China Medical University Hospital, Taichung, Taiwan.
Hung
Yao-Ching
YC
Li
Tsai-Chung
TC
Yang
Tung-Chuan
TC
Chen
Huey-Yi
HY
Lin
Cheng-Chieh
CC
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000191:economics; D002512:Cephalothin / Q000627:therapeutic use; D004334:Drug Administration Schedule; D005260:Female; D005839:Gentamicins / Q000627:therapeutic use; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000191:economics / Q000379:methods*; D010535:Laparoscopy; D019990:Perioperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D005839:Gentamicins; D002512:Cephalothin