[A comparative study of the efficacy of antibiotic prophylaxis with cephalosporins in operative gynecology].

The article presents the results of a comparative study on the efficacy of perioperative prophylaxis with cefalosporins in abdominal gynaecological operations. A total of 155 women meeting certain inclusion criteria were operated on and were randomly assigned to one of the following regimens: Cefoxitin 3 x 1 g--14 subjects, Cefotetan 2 x 1 g--43 subjects, Cefalotin 3 x 2 g for 24 hours--27 subjects, Cefalotin 3 x 2 g for 72 hours--41 subjects and a control group of 30 subjects without prophylaxis. The course of the postoperative period, the hospital stay and the average costs in each group were assessed and compared. None of patients receiving any prophylaxis developed infectious complications, while such complications occurred in 10% of the control without prophylaxis. The authors conclude that antibiotic prophylaxis effectively prevent the infectious complications and shortens the postoperative hospital stay. Despite its narrower anti-bacterial spectrum Cefalotin is not inferior in its efficacy to the second and the third-generation cefalosporins. While providing equal effect, the 24-hours Cefalotin regimen is from 2.8 to 4.9 times cheaper then the other prophylaxis regimens and is twice cheaper than the no-prophylaxis regimen. The longer 72-hours Cefalotin scheme shows no advantages to the 24-hours one but almost triples the expenses. Additional antibacterial treatment in the postoperative period needs more precise indications since unequivocal reasons for its administration are missing in a number of cases.