Single dose ceftriaxone versus single dose cefuroxime plus metronidazole for preventing febrile morbidity and urinary tract infection in vaginal hysterectomy

Abstract

Objective: To compare the prophylactic efficacy o f 1 g ceftriaxone with 1,5 g cefuroxime + 0.5 g metronidazole for febrile morbid ity and urinary tract infection in patients undergoing vaginal hysterectomy. Study design: A prospective, randomized, comparative, non-blinded study with at least 100 patients on each side. The two-sample /-test was used for testing equality o f two means and the x 2 test was used for pair differences. Results: Single dose cefuroxime + metronidazole and ceftriaxone were equally effective in preventing febrile morbidity postoperatively. Additionally ceftriaxone was more effective in sterilizing pre-operatively existing bacteriuria.

Urinary tract infections after pelvic floor gynecological surgery: prevalence and effect of antimicrobial prophylaxis. A systematic review

“…Also, Van der Linden et al found no difference in UTI rates in patients undergoing vaginal hysterectomy with or without colporrhaphy and receiving amoxicillin/clavulanate versus cefuroxime plus metronidazole [14]. Brouwer and Hoogkamp-Korstanje did not find a statistically significant difference regarding development of UTI in patients receiving single-dose ceftriaxone or cefuroxime plus metronidazole prophylaxis [15]. In 2004, Rogers et al, in a total of 435 patients of which 59% underwent a retropubic urethropexy and in whom suprapubic catheterization was used, found that a preoperative dose of cephalosporin plus postoperative nitrofurantoin monohydrate was associated with less development of UTI than the use of preoperative cephalosporin and placebo (7.2% vs 19.8%) [16].…”

A Meta‐Analysis of Randomized, Controlled Trials Assessing the Prophylactic Use of Ceftriaxone. A Study of Wound, Chest, and Urinary Infections

“…1. After triage, there were 90 remaining studies that were included in the meta‐analysis [6–9, 12–96]. Of these 44 were sourced from Medline, an additional 8 from Embase, 10 from the Cochrane registers, 10 from scientific meetings, and 18 from identified references.…”

“…The difference in antibiotic performance was significant after general abdominal–gastrointestinal operations (including studies that looked at a range of abdominal surgery, and colorectal surgery but not for upper gastrointestinal or biliary surgery [6–9, 13, 15, 20, 23, 24, 30, 36, 43, 46, 51, 55, 57, 62, 77] and pelvic surgery. The differences were most significant after colorectal surgery ( n = 6; OR 0.3; 95% CI 0.16–0.58; p < 0.001) and obstetric and gynecological (O&G) surgery ( n = 9; OR 0.53; 95% CI 0.34–0.69) [17, 39, 47, 63, 68, 71, 73, 75, 79]. There was no difference in antibiotic performance for clean operations, which included mainly cardiac surgery and orthopedic operations [27, 37, 48, 65, 69].…”

“…Odds ratio and 95% CI Anderson [13] Beam [69] Beksac [71] Blatzas [15] Brouwer [73] Cardamakis [17] Cucchiaro [74] El-Mufti [20] Fejgin [68] Franceschini [23] Garcia [24] Garotta [25] Geroulanos [27] Harmes [75] Harnoss [30] Kellum [77] Kracht [36] Kriaras [37] Kunz [39] Lang [41] Luke [43] Lumley [6] Morris [45] Nyam [46] Papageorgiou [47] Parker [78] Periti [48] Periti [51] Periti [49] Rotman [55] Schweizer [57] Stiver [79] Thomas [62] von Mandach [63] Winter [65] Woodfield [9] Zhu [67] 0.01 0.1 1 10 100…”

Postprostatectomy Orchitis: Reduction in Incidence Using Perioperative Ceftriaxone and Postoperative Ciprofloxacin

“…Ceftriaxone is a longacting, third-generation cephalosporin which has shown good results in the treatment and prophylaxis of infections in various parts of the body [10]. It has shown in vitro and in vivo activity against known pathogens that cause infection following vaginal hysterectomy [13], against colorectal organisms and against organisms that cause urinary infection [14]. Because of its relative high cost in our economically impoverished community we were unable to give more than the first dose.…”