Single dose tinidazole prophylaxis in hysterectomy

The results of this randomized double blind, placebo controlled trial of a single oral dose of 2 g tinidazole or placebo approximately 12 hours before hysterectomy showed the incidence of infective morbidity in patients who received placebo was 12.2% compared with 1.9% in patients who received tinidazole, (p = 0.045). The mean serum concentration of tinidazole at the time of surgery was 35 mcg/ml, which was well in excess of the minimum concentration required to inhibit all of the 95 anaerobes isolated in this study. Serum tinidazole concentration remained adequately inhibitory for at least 24 hours after surgery. The ability of tinidazole prophylaxis to reduce further our already low rate of febrile morbidity was considered a worthwhile gain. It is now Unit policy to give this agent prophylactically to all patients if the integrity of the vagina is likely to be breached at the time of surgery.