The effect of antibiotic prophylaxis on patients undergoing total abdominal hysterectomy. I. Effect on morbidity.

A prospective, double-blind study was conducted to evaluate the effect of cephalosporins on morbidity of women undergoing total abdominal hysterectomy. Each patient received a 5 day course of active drug or placebo beginning the night before surgery. Microbiologic studies, including culture and antibiotic sensitivities, were done on each patient pre- and postoperatively. Of the 46 women who received placebo, eighteen (39 per cent) were classified as morbid. Causes of morbidity included operative bed, wound, respiratory, or urinary tract infections. E. coli was the organism most frequently isolated. Of the 47 women who received cephalosporin prophylaxis, seven (15 per cent) were classified as morbid. The causes of the morbidity were often poorly defined, and cephalosporin-resistant organisms were recovered more often from these women than from those on placebo. There was no significant difference in length of hospital stay between women who received prophylaxis and those who did not.