Randomized, double-blind comparison of the efficacies, costs, and vaginal flora alterations with single-dose ceftriaxone and multidose cefazolin prophylaxis in vaginal hysterectomy.

Antimicrobial Agents and Chemotherapy
H G StiverJ McLeod

Abstract

A comparison of efficacies, costs, and effects on vaginal microflora of one preoperative and three postoperative 1-g doses of cefazolin versus those of one preoperative 1-g dose of ceftriaxone was done with 65 and 73 women, respectively, undergoing elective vaginal hysterectomy. Patient infection rates were not statistically different between the cefazolin group (six events in 6 of 73 patients [8.2%]) and the ceftriaxone group (11 events in 9 of 65 patients [13.8%]). Side effects, including diarrhea, were minimal and similar between the two groups. Significant shifts in the cervicovaginal microflora of the patients occurred postoperatively, with a marked increase in enterococci and a drop in nonenterococcal streptococci. No shifts among aerobic, facultative gram-negative rods and staphylococci were observed. Among the anaerobes, a significant decrease in the number of patients harboring nonsporulating, gram-positive rods and a less striking concomitant increase in Bacteriodes species and members of the family Peptococcaceae were noted. No qualitative differences were noted between the two groups that received prophylactic therapy. Aside from enterococci, cefazolin or ceftriaxone resistance among vaginal isolates (greater than o...Continue Reading

References

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Citations

Apr 11, 2008·International Urogynecology Journal and Pelvic Floor Dysfunction·Matthew E FalagasAris Antsaklis
Aug 1, 1995·European Journal of Obstetrics, Gynecology, and Reproductive Biology·W K Brouwer, J A Hoogkamp Korstanje
May 23, 2007·Clinical Drug Investigation·Silvano EspositoPaola Venturino
Jul 14, 2012·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Natacha PhoolcharoenSurasith Chaithongwongwatthana
May 25, 2016·International Journal of Antimicrobial Agents·Konstantinos Z VardakasMatthew E Falagas
Nov 18, 2017·Journal of Medical Case Reports·Miku TamuraKatsuya Sugawara
Dec 6, 2018·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Aurora Pop-VicasNasia Safdar
Jan 1, 1994·Annales Françaises D'anesthèsie Et De Rèanimation·J BeytoutH Laurichesse

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