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Low Dose Prophylactic Antibiotics in Vaginal Hysterectomy

From the Departments of Obstetrics and Gynecology at Mercy Hospital and Medical Center and University of California, San Diego, California

Abstract

The use of a prophylactic antibiotic in elective vaginal hysterectomy with either anterior and/or posterior colporrhaphy was evaluated in a prospective, double-blind, controlled study. Defining morbidity as: a temperature of 100.4° F or greater for 2 days (excluding the first 48 hours), a vaginal cuff abscess, or a urinary tract infection, the infectious morbidity was 52% in the control group and 9% in the drug-treated group. Arguments arc proposed for a stricter definition of temperature morbidity. Using the above criteria for morbidity, but requiring that the temperature be equal to or greater than 101° F for two readings at least 4 hours apart (after the first 48 hours), the infectious morbidity was 32% in the control group and 8% in the drug-treated group. The concept of prophylactic antibiotic usage in vaginal surgery is discussed.