ANTIMICROBIAL PROPHYLAXIS IN HYSTERECTOMIES - A DOUBLE-BLIND, RANDOMIZED, COMPARATIVE-STUDY OF A SINGLE-DOSE OF PIPERACILLIN (2 G) VERSUS ASINGLE-DOSE OF AMOXICILLIN-CLAVULANIC ACID (2.2 G)

A double-blind, randomized comparative study of piperacillin (2 g) ver sus amoxicillin-clavulanic acid (2.2 g) as a single dose 30 minutes be fore the initiation of hysterectomy was performed. A total of 595 pati ents (of which 307 were in the piperacillin group) were evaluable for efficacy. Infectious complications were infrequent in both arms. One c ase of (mild) sepsis was observed in the piperacillin group and two ca ses of wound infection were observed in the amoxicillin-clavulanic aci d group. Urinary tract infection was observed in 5.5% of the patients in the piperacillin group and in 2.4% of the amoxicillin-clavulanic ac id group. A relatively high incidence of asymptomatic bacteriuria was seen in both groups: 11.8% in the piperacillin group and 8.7% with amo xicillin-clavulanic acid. A marked difference was seen between the two different hospital locations: a 15% incidence in the hospital where m idstream urine was used for culture (Sittard), versus 5% in the hospit al where catheter urine was used (Geleen). It is concluded that both a ntibiotics are associated with a low rate of infectious complications and that catheter urine must be used for sample collection.