Single-dose cephalosporin for prevention of major pelvic infection after vaginal hysterectomy: Cefazolin versus cefoxitin versus cefotaxime

David L. Hemsell, Roger E. Bawdon, Patricia G. Hemsell, Brenda J. Nobles, Edward R. Johnson, Molly C. Heard

Research output: Contribution to journalArticle

22 Scopus citations


Antimicrobial overutilization accelerates the development of bacterial resistance. A prospective, randomized, blinded clinical trial of vaginal hysterectomy prophylaxis was designed to compare the efficacy, safety, and costs of cefazolin with those of cefoxitin and cefotaxime. Sixteen women (7.5%) developed febrile morbidity only, 10 (4.7%) developed major pelvic infection requiring parenteral antimicrobial therapy, and neither clinical nor laboratory adverse reactions of significance were observed. Anemia, diabetes, and additional surgical procedures were associated with a significantly increased incidence of postoperative infection; no regimen was more protective for women with or without these risk factors. Infections almost doubled hospital stay and the charges for health care. Diagnosis-related group reimbursement would have been more than $1,300 less than the mean hospital charge for women who developed infection. Utilizing cefazolin for prophylaxis and reserving cefoxitin and cefotaxime for therapy is cost and antimicrobial efficient.

Original languageEnglish (US)
Pages (from-to)1201-1205
Number of pages5
JournalAmerican Journal of Obstetrics and Gynecology
Issue number5
Publication statusPublished - 1987



  • Prophylaxis
  • single dose
  • vaginal hysterectomy

ASJC Scopus subject areas

  • Medicine(all)
  • Obstetrics and Gynecology

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