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At least 19 recordsLinked to original sources
PubMed1990

Antimicrobial prophylaxis in gynaecological and obstetric surgery.

Gynaecologic and obstetric surgery generally is prone to infections caused by bacteria from vagina. The vaginal flora contains normally more than 40 different microorganisms. Some of them are obligate pathogens, such as Chlamydia trachomatis, Neisseria gonorrhoeae and serogroup B streptococci, for other microbial species, like mycoplasmas and staphylococci, the pathogenicity is uncertain. The vaginal flora is under the influence of a great number of variables, such as endocrine factors, life style, contraception, and the use of tampons/pads. The recent literature on antibiotic prophylaxis in gynaecology and obstetrics is surveyed. The conclusions are: Antibiotic prophylaxis is recommended in: Abdominal hysterectomy (in high risk cases), in vaginal hysterectomy, fertility surgery, elective abortion and miscarriage (in carriers of C. trachomatis or N. gonorrhoeae), in cerclage (in endocervical colonization), Caesarean section (in high risk cases), and premature rupture of membranes. Great importance is attached to the prevention of infection of the neonates, with emphasis on the transmission of serogroup B streptococci and herpes simplex virus. The prevention of postoperative and postpartum urinary tract infections is discussed.

Anti-Bacterial Agents↗
PubMed1988

Prophylaxis in gynaecological and obstetric surgery: a comparative randomised multicentre study of single-dose cefotetan versus two doses of cefazolin.

Antimicrobial prophylaxis is recommended in all clean-contaminated surgery where the critical threshold of number and virulence of the contaminating organisms with respect to host resistance is reached. Obstetric and gynaecological surgery is clean-contaminated and risk of infection due to aerobic and anaerobic bacteria without prophylaxis can be quantified at 30-40% for vaginal hysterectomy, 10-35% for abdominal hysterectomy and 10-34% for caesarean section. To assess the role of two different cephalosporins as short term prophylaxis, we carried out a multicentre randomised study involving a single 2 g i.v. dose of cefotetan in comparison with two doses of cefazolin (2 g i.v. before surgery and after 8 hours). Criteria for exclusion were: exposure to antibiotics within 7 days, preoperative infection, hypersensitivity to beta-lactams. Four hundred and sixty patients entered the study, of which 229 received cefotetan and 231 cefazolin. No significant differences in mean age, obesity, preoperative weight loss, diabetes, type of disease, type of surgery (vaginal or abdominal hysterectomies and caesarean sections) and number of pregnancies and abortions existed between the two groups of patients. The total rate of infected patients undergoing hysterectomy was 8.6% (13/151) in the cefotetan group and 17.4% (29/167) in the cefazolin group (p less than 0.05). This difference was due to cases of symptomatic bacteriuria and antibiotic retreatment, while wound infections were not significantly different (2.6% and 1.8% respectively). Among patients undergoing caesarean section, 9 of 78 (11.5%) and 7 of 64 (10.9%) were infected following cefotetan and cefazolin, respectively (not significant). Cefotetan mean tissue concentrations in gynaecological organs were higher than those of cefazolin (25.5-44.8 vs. 7.4-9.5 mg/kg).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Prophylactic antibiotics in gynecologic and obstetric surgery.

Preventing infections at operative sites has long been a goal of gynecologic and obstetric surgeons. These infections constitute the leading cause of morbidity after both elective and emergent surgical procedures. Serious sequelae such as bacteremia, septic shock, phlegmon, pelvic abscess, septic pelvic thrombophlebitis, wound abscess, and fascial dehiscence may complicate primary infections, with devastating results. Early attempts to prevent postoperative infections concentrated on aseptic techniques and the modification of surgical skills. Soon after the introduction of antibiotics into clinical medicine, surgeons began to administer these drugs to clinically uninfected women to prevent operative-site infection; that practice has been documented and assessed in a large volume of literature. This article reviews the chronologic development of prospective data in the areas of benign gynecology, obstetrics, gynecologic oncology, and infertility and makes recommendations regarding antibiotic prophylaxis of infections associated with surgical procedures.

Abortion, Induced↗
PubMed1991

[Antibiotic prophylaxis in obstetric surgery. Experience with a sulbactam-ampicillin combination].

Antibiotic prophylaxis reduces the incidence of infections after some types of surgical interventions; in Obstetrics it can prevent infections in high risk situations. Infections can occur in particular situations, even in cesarean sections (CS) at low risk. The incidence of puerperal endometritis is variable in literature, while the incidence of pelvic or surgical wound infections is 3.8% in elective CS with respect to 7.5% in emergency CS. This study verifies the efficacy of the sulbactam-ampicillin association (Unasyn, Pfizer) in the prophylaxis of all cesarean sections, complicated or not. Unasyn was administrated one hour prior to CS and 8 and 16 hours after CS in 162 patients. Therapy was continued in 8 cases because of high risk for infection. The evaluation of the efficacy of the drug was based on clinical criteria. There were no complications or fever recorded and no toxic or allergic reactions occurred. Antibiotic prophylaxis is recommended for all patients undergoing CS.

Adult↗