[Local administration of metronidazole before hysterectomy--effect on infectious morbidity. A prospective study]

A prospective clinical trial was designed to examine the influence of a local application of metronidazole on postoperative infectious morbidity in 134 women undergoing vaginal and in 108 women undergoing abdominal hysterectomy. 116 patients received on the evening before hysterectomy a vaginal suppository of metronidazole (500 mg). The control group (126 patients) had no metronidazole prophylaxis. All patients, who underwent vaginal hysterectomy, were given additionally a single-shot prophylaxis with 1500 mg cefuroxim. With regard to febrile morbidity, urinary tract infection and abdominal wound or pelvic infection, there was a significant decrease in infectious morbidity. In women undergoing vaginal hysterectomy the infectious morbidity was reduced from 35.7% to 20.3% (p less than 0.05) in spite of systemic prophylaxis. In cases with abdominal hysterectomy, we saw a decrease from 64.3% to 26.9% (p less than 0.001). There was no effect on the incidence of urinary tract infections. Local prophylaxis with metronidazole in abdominal hysterectomy and additional to a systemic prophylaxis in vaginal hysterectomy reduces the infectious morbidity in our patients.