Single-dose ceftriaxone versus multi-dose cefotaxime antimicrobial prophylaxis in gynecologic and obstetrical surgery. Preliminary results of a multicenter prospective randomized study.

This multicenter, prospective and randomized study on 355 patients demonstrates the equal efficacy of two short-term antimicrobial prophylactic regimens in gynecologic and obstetrical surgery involving a single dose of a long-acting cephalosporin, ceftriaxone, in comparison with a multiple cefotaxime dose. Among the cefotaxime and ceftriaxone groups which underwent abdominal hysteroctomy, 15 of 112 (13.4%) and 20 of 97 (20.6%) patients developed infections respectively. Four vaginal hysterectomy patients out of 20 (20%) on cefotaxime regimen and 4 of 25 (16%) who received ceftriaxone, became infected (febrile morbidity, wound infections, bacteriuria and infectious complications at a non-surgical site). Also among the cefotaxime and ceftriaxone groups of emergency or elective cesarean sections the differences on the incidence of infections are not statistically significant.