Grossman J H, Adams R L
Obstet Gynecol. 1979 Jan;53(1):23-6.
One objection occasionally raised against the use of routine antibiotic prophylaxis for pelvic surgery is the concern that the flora of treated patients will be altered, thus favoring the emergence of different, potentially more resistant organisms. This report summarizes experience with 100 women undergoing elective hysterectomy who were subjected to short-term cefazolin, penicillin, or placebo prophylaxis. The changes in preoperative versus postoperative flora were similar among antibiotic-treated and placebo-treated groups. In general, postoperative isolation of gram-negative aerobes and Bacteroides sp increased, and isolation of gram-positive aerobes (except group D streptococci) decreased in antibiotic-treated and placebo-treated groups. The clinical implications of these findings are discussed.
对于盆腔手术常规使用抗生素预防措施，偶尔会有人提出反对意见，即担心接受治疗的患者菌群会发生改变，从而有利于不同的、可能更具耐药性的微生物出现。本报告总结了100例行择期子宫切除术的女性患者的经验，这些患者接受了短期头孢唑林、青霉素或安慰剂预防治疗。抗生素治疗组和安慰剂治疗组术前与术后菌群的变化相似。一般来说，抗生素治疗组和安慰剂治疗组术后需氧革兰阴性菌和拟杆菌属的分离率增加，而需氧革兰阳性菌（除D组链球菌外）的分离率下降。文中讨论了这些发现的临床意义。
