[Comparative study on the question of systemic chemoprophylaxis following gynecological surgery]

The incidence of delayed wound healing and urinary tract infections was studied in 2 randomized groups of post-operative gynecological patients, one of which was given systemic antibiotic prophylaxis and the other not. 143 women were given Bactrim in a standard dose of 2 x 2 tablets or ampoules daily, commencing preoperatively during and continuing until the eighth postoperative day. The control group received placebos parenterally and orally for the same period. The incidence of complications in wound healing, of subfebrile and febrile states, urinary tract infections and micturition difficulties following removal of the catheter was significantly lower in the group who had undergone antibiotic therapy. 83% of this group, compared with 68% in the control group, were discharged after the normal hospital stay. In 51% of the control group a chemotherapy or antibiotic course had to be given secondarily to combat infection, the commonest indications being urinary tract infections or pyrexia for several days. The drawbacks were side effects of the systemic chemoprophylaxis, such as skin eczema (6%) and gastrointestinal disturbances, as well as a tendency to infections with problem bacteria requiring treatment with reserve antibiotics. It is concluded that routine postoperative antibiotic prophylaxis, despite its favourable effect on infections morbidity as a compromise between optimum treatment for the individual and general medical interest, must be prescribed on an individual basis.