RANDOMIZED STUDY OF ANTIBIOTIC-PROPHYLAXIS FOR GENERAL AND GYNECOLOGICAL SURGERY FROM A SINGLE-CENTER IN RURAL AFRICA

In a district rural hospital in Uganda, 850 surgical patients were eva luated prospectively over a 3-year period to compare the clinical effi cacy of conventional postoperative penicillin therapy with single-dose ampicillin prophylaxis for hernia repair and ectopic pregnancy, and w ith single-dose ampicillin-metronidazole prophylaxis for hysterectomy and caesarean section. The high rate of postoperative infection usuall y encountered in African hospitals after conventional treatment with p enicillin for 7 days was significantly reduced with the new regimen: f rom 7.5 to 0 per cent in hernia repair and from 10.7 to 2.4 per cent i n ectopic pregnancy; from 20.0 to 3.4 per cent in hysterectomy and fro m 38.2 to 15.2 per cent in caesarean section, Length of hospital stay and postoperative mortality rates were also significantly reduced, Sin gle-dose ampicillin prophylaxis with or without metronidazole, althoug h rarely used in developing countries, is more cost effective than sta ndard penicillin treatment.