Single-dose intravenous tinidazole prophylaxis in abdominal hysterectomy

In 100 patients undergoing abdominal hysterectomy, a double-blind study was undertaken to evaluate the efficacy of prophylactic tinidazole treatment in diminishing the postoperative infection rate. The patients treated received a single dose of 1,600 mg tinidazole i.v. during 2 h preoperatively. One patient each from the placebo and treatment groups was excluded since the operations was ultimately not hysterectomy. The two groups of women, 49 in each, were comparable with regard to age, previous obstetrical and gynecological history, and reason for hysterectomy. Significant infectious complications (pelvic cellulitis, vaginal cuff abscess, pelvic abscess) were observed in 9 (18.4%) of the 49 placebo patients, but in only 3 (6.1%) of the 49 tinidazole-treated patients. Mild or mode rate wound infections were found in 2 patients of each group (4%). Urinary tract infections were found in 10 placebo (20.4%) and 12 tinidazole-treated patients (24.5%). Among patients developing cuff abscesses, Bacteroides was the most frequently isolated anaerobic genus, B. bivius being the predominant species, while bacteria of enteric origin such as Escherichia coli and Streptococcus faecalis were the most common aerobic isolates. The results of the present study indicate that an intravenous preoperative single-dose tinidazole prophylaxis might reduce the risk of major pelvic infection following hysterectomy, the causative microorganisms usually being a mixture of aerobic and anaerobic bacteria.