Pharmaceutisch Weekblad

, Volume 12, Issue 6, pp 284–288 | Cite as

Vaginal hysterectomy: cefuroxime, metronidazole or both?

  • F. M. Kauer
  • J. Wijma
  • W. L. Manson
Antibiotics in Gynaecology and Obstetrics


A randomized double-blind prospective study on the efficacy of single-dose antibiotic prophylaxis compared cefuroxime versus metronidazole versus the combination of both agents in vaginal hysterectomy. Overall antibiotic prophylaxis was effective in abscess prevention (one abscess in 68 patients). In the metronidazole group a significantly higher grade of morbidity was observed: febrile morbidity 41% versus 4% in the two other groups; bacteriuria 73% versus 17% in the cefuroxime group, versus 13% in the combined group; urinary tract infection 23%, versus 0% in the two other groups; post-operative prescription of antibiotics 41%, versus 0% in the two other groups. Febrile morbidity and bacteriuria correlated positively withEscherichia coli andProteus spp. These micro-organisms were recovered significantly more often from the vagina of patients in the metronidazole group. Cefuroxime was successful, metronidazole failed in the prevention of minor morbidity. We could not observe any effect from the addition of metronidazole to the cefuroxime prophylaxis.


Cefuroxime Drug therapy Hysterectomy Metronidazole Pre-operative care 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Brouwer WK, Kuiper KM, Langbroek W. The efficacy of prophylaxis with cefuroxime and metronidazole in gynaecological surgery. Res Clin Forums 1984;6:25–33.Google Scholar
  2. 2.
    Leabeater B, Kingston J. Cefuroxime and metronidazole in gynaecological surgery. Br J Obstet Gynaecol 1981;88:543–7.PubMedGoogle Scholar
  3. 3.
    Wijma J, Kauer FM, Van Saene HKF, Van de Wiel HBM, Janssens J. Antibiotics and suction drainage as prophylaxis in vaginal and abdominal hysterectomy. Obstet Gynecol 1987;70:384–8.PubMedGoogle Scholar
  4. 4.
    Ledger WJ, Sweet RL, Headington JT. Prophylactic cephaloridine in the prevention of post-operative pelvic infections in premenopausal women undergoing vaginal hysterectomy. Am J Obstet Gynecol 1973;115:766–74.PubMedGoogle Scholar
  5. 5.
    Hamod KA, Spence MR, Rosenshein NB, Dillon MB. Single-dose and multidose prophylaxis in vaginal hysterectomy: a comparison of sodium cephalothin and metronidazole. Am J Obstet Gynecol 1980;136:976–9.PubMedGoogle Scholar
  6. 6.
    Heginbotham D, Rutherford AM. Metronidazole in the prophylaxis of anaerobic infections in gynaecological surgery. NZ Med J 1979;89:246–8.Google Scholar
  7. 7.
    Onderdonk AB, Bartlett JG, Louie T, Sullivan-Seigler N, Gorbach SL. Microbial synergy in experimental intra-abdominal abscess. Infect Immun 1976;13:22–6.PubMedGoogle Scholar
  8. 8.
    Van Saene HKF, Stoutenbeek CP, Miranda DR, Zandstra DF. A novel approach to infection control in the intensive care unit. Acta Anaesthesiol Belg 1983;34:193–208.PubMedGoogle Scholar
  9. 9.
    Nissen D, Goldstein AI. A prospective investigation of the etiology of febrile morbidity following abdominal hysterectomy. Am J Obstet Gynecol 1972;113:111–4.PubMedGoogle Scholar
  10. 10.
    Shapiro M, Munoz A, Tager IB, Schoenbaum SC, Polk BF. Risk factors for infection at the operative site after abdominal or vaginal hysterectomy. N Engl J Med 1982;307:1661–6.PubMedGoogle Scholar
  11. 11.
    Kass EH. Chemotherapeutic and antibiotic drugs in the management of infections of the urinary tract. Am J Med 1955;18:764–81.CrossRefPubMedGoogle Scholar
  12. 12.
    Hamod KA, Spence MR, King TM. Prophylactic antibiotics in vaginal hysterectomy: a review. Obstet Gynaecol Surv 1982;37:207–16.Google Scholar

Copyright information

© Royal Dutch Association for Advancement of Pharmacy 1990

Authors and Affiliations

  • F. M. Kauer
    • 1
  • J. Wijma
    • 2
  • W. L. Manson
    • 3
    • 4
  1. 1.Department of Obstetrics and GynaecologyRoman Catholic Hospital GroningenNZ Groningenthe Netherlands
  2. 2.Department of Obstetrics and GynaecologyUniversity Hospital GroningenRB Groningenthe Netherlands
  3. 3.Department of Medical MicrobiologyRoman Catholic HospitalGroningen
  4. 4.Regional Public Health LaboratoryGroningenthe Netherlands

Personalised recommendations