Comparative efficacy of cefotaxime and cefazolin as prophylaxis against infections following elective hysterectomy.
The safety and efficacy of cefotaxime and cefazolin as prophylaxis against posthysterectomy infections were compared in a prospective, randomized study. A total of 118 women undergoing elective vaginal or abdominal hysterectomy were randomly assigned to receive either (1) cefotaxime perioperatively, (2) cefotaxime perioperatively and 24 hours postoperatively, or (3) cefazolin perioperatively and 24 hours postoperatively. In all regimens, the initial antibiotic dose was given intramuscularly and subsequent doses were given intravenously. No postoperative pelvic or wound infections developed in patients in any of the three study groups during the hospital stay or in the 30-day follow-up period. No side effects or changes in laboratory test values attributable to the antibiotics were noted. The results of the study indicate that (1) standard one-day regimens of cefotaxime and cefazolin are equally safe and effective as prophylaxis against posthysterectomy infections, and (2) a brief, three-dose perioperative course of cefotaxime is as effective as a standard one-day regimen of either cefotaxime or cefazolin and has the advantages of reduced cost and greater convenience.