The effect of antibiotic prophylaxis on patients undergoing vaginal operations. I. The effect on morbidity

A prospective, double-blind study was conducted to evaluate the effect of cephalosporins on morbidity in women undergoing vaginal hysterectomy. Each patient received a five-day course of an active drug or a placebo beginning the night before operation. Microbiological studies, including culture and antibiotic sensitivities, were done on each patient pre- and post-operatively. Of 23 women who received the placebo, 11 (48 percent) were classified as morbid. They had either an operative bed infection or a urinary tract infection. Only a small number of cephalosporin-resistant organisms were involved in these infections. Of the 25 women who received the cephalosporins, none (0 per cent) was classified as morbid. A small increase in the number of cephalosporin-resistant organisms (most notably Pseudomonas aeruginosa) was found postoperatively. Four patients were readmitted with pelvic infections after their original discharge. Microbiological data and a discussion of these infections are presented.