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DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20160839
Research Article
Department of Obstetrics and Gynaecology, SHKM Govt. Medical College, Nalhar, Haryana, India
Department of Physiology, SHKM Govt. Medical College, Nalhar, Haryana, India
3
Department of Anatomy, SHKM Govt. Medical College, Nalhar, Haryana, India
2
Page 980
METHODS
Women who were scheduled to undergo hysterectomy for
benign diseases and elective cesarean deliveries were
enrolled in this trial. The cesarean was considered
elective if the procedure was performed in absence of
labor and before rupture of membranes. The exclusions
were made for the patients who gave history of
hypersensitivity to penicillin or cephalosporin; or signs of
pre-existing infections and those who had received
antibiotic therapy within the last seven days prior to
surgery. The patients received information concerning
objectives of the trial prior to surgery and written consent
was obtained. The study protocol was approved by the
ethical committee of the hospital. Patients were randomly
allocated to one of the two regimens: amoxicillinclavulanic acid 2.4 g (Augmentin, GlaxoSmithCline) and
cefazolin 2 g (Reflin, Ranbaxy). Study medication was
given intravenously at the time of induction of anesthesia
(15-30 min before incision). In the case of extensive
blood loss (>1000 ml) or a surgical duration of longer
than 3 hours, a second dose of antibiotic was
administered as a single dose immediately after clamping
the umbilical cord. Surgery was performed by the staff,
gynaecologists. In women who underwent vaginal
hysterectomy for prolapsed, the catheter was retained for
two days.
After surgery, each patient was assessed daily until they
were discharge from the hospital. Two main outcome
Parameters
No. of patients
Mean age (in year)
BMI
AssociatedSystemic disease
Type of surgery
Hysterectomy
AMX/CL
36
47.6
23.7
6
TAHBSO
(n=24)
VH/LAVH
(n=12)
Cefazolin
24
43.2
23
4
TAHBSO
(n=21)
VH/LAVH
(n=3)
p-value
0.02
0.5
0.05
p-value
0.05
0.3
0.29
Parameters
Mean duration of operation (in min.)
Mean blood loss (in ml)
Mean days of catheterisation
Hysterectomy
AMX/CL Cefazolin
150.9
147.2
441.1
508.3
1.7
1.2
p-value
0.71
0.13
0.02
Cesarean
AMX/CL
45.3
567.21
1
Cefazolin
45.5
523.8
1.01
p-value
0.73
0.22
0.36
Parameters
Mean post-operative hospital
stay (in days)
Wound Infection
Pelvic Cellulitis
Endometritis
Asymptomatic bacteriuria
Total Infections
Hysterectomy
AMX/CL
Cefazolin
p-value
Cesarean
AMX/CL
Cefazolin
p-value
8.6
9.5
0.27
10.6
0.46
2
0
2
4
0
1
2
3
1
0.84
1
1
3
1
2
6
2
1
1
4
0.82
1
0.76
0.51
DISCUSSION
Many of the studies that have supported the development
of antimicrobial prophylaxis guidelines are quite old.
Moreover, there is a great variation in the use of
antimicrobial
prophylaxis
by
surgeons
during
hysterectomy. Trolo and Kocak have evaluated AMX/CL
CONCLUSIONS
8.
9.
10.
REFERENCES
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