Short course of prophylactic antibiotics in laparoscopically assisted vaginal hysterectomy

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

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.

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).

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.