[Recommendations for the systemic perioperative prevention of infections in gynecology and obstetrics].

Antibiotic prophylaxis for gynecologic and obstetric surgery is reviewed. Numerous clinical studies conducted under controlled conditions have established and confirmed the beneficial effects of short term (preferentially single-dose) perioperative antibiotic prophylaxis for various procedures. Cephalosporins, particularly of the first generation, have been used extensively despite the fact that their antimicrobial spectrum does not include all pathogens recovered from postsurgical infections in gynecology. Perioperative antibiotic prophylaxis is effective in reducing the incidence of infection-related morbidity and mortality of vaginal hysterectomy, especially in premenopausal women. This protective effect is less pronounced for abdominal hysterectomy. The incidence of postoperative infections at a particular hospital should be used as guideline as to whether antibiotic prophylaxis will be beneficial or not for these patients. The same applies to C-sections, for which antibiotic prophylaxis should be administered to high risk patients only, such as secondary C-section or patients with severe underlying diseases. The optimal timing appears to be after cord clamping, which prevents transfer of the antibiotic to the newborn.