TY - JOUR
T1 - Single-dose cephalosporin for prevention of major pelvic infection after vaginal hysterectomy
T2 - Cefazolin versus cefoxitin versus cefotaxime
AU - Hemsell, David L.
AU - Bawdon, Roger E.
AU - Hemsell, Patricia G.
AU - Nobles, Brenda J.
AU - Johnson, Edward R.
AU - Heard, Molly C.
N1 - Funding Information:
From the Departments of Obstetrics and Gynecology and Anesthe-siology, University of Texas Health Science Center, Southwestern Medical School, Parkland Memorial Hospital. Supported by a Grant-in-Aid from Eli Lilly & Company, Indian-apolis, Indiana. Received for publication September 8, 1986; revised January 8, 1987; accepted January 22,1987. Reprint requests: David L. Hemsell, M.D., Department of Obstetrics and Gynecology, University of Texas Health Science Center at Dallas, 5323 Harry Hines Blvd., Dallas, TX 75235.
PY - 1987/5
Y1 - 1987/5
N2 - 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.
AB - 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.
KW - Prophylaxis
KW - single dose
KW - vaginal hysterectomy
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U2 - 10.1016/0002-9378(87)90144-X
DO - 10.1016/0002-9378(87)90144-X
M3 - Article
C2 - 3555090
AN - SCOPUS:0023221758
SN - 0002-9378
VL - 156
SP - 1201
EP - 1205
JO - American journal of obstetrics and gynecology
JF - American journal of obstetrics and gynecology
IS - 5
ER -