[How to determine the prophylactic effect on postoperative infections]

With the cooperation of 13 medical institutions in the Tokyo area, the methods to determine the prophylactic effect on postoperative infections in gynecological surgery were evaluated. Two hundred and ninety-nine patients were enrolled for the study of postoperative infections, febrile morbidity and fever index following abdominal (275) and vaginal (24) hysterectomies. Prophylactic cefotiam (CTM) of 1 gram was intravenously administered twice a day postoperatively for 3 to 5 days. The rates of postoperative infections were 5.1% (14/275) in abdominal hysterectomy and 4.2% (1/24) in vaginal hysterectomy. The febrile morbidity (57.1% = 8/14) and fever index (52.3 +/- 41.1 degree hours) in the infection group were approximately about 4 times higher than those (12.3% = 32/261, and 15.6 +/- 13.7 degree hours, respectively) in the non-infection group. No significant differences were observed in age, body weight, height of patients, period of operation and blood loss between these 2 groups. These data suggested that febrile morbidity and fever index were able to indicate the prophylactic effect of antibiotics on patients undergoing abdominal and vaginal hysterectomies.