Antimicrobial prophylaxis in obstetric and gynecological surgery

A major problem in obstetric and gynecological surgery, especially followin g cesarean section in labor, total vaginal or abdominal hysterectomy, or my omectomy, is postoperative wound infection. Consequently, the use of antimi crobial prophylaxis for cesarean section and for gynecological surgery has been advocated and shown to be effective in reducing postoperative morbidit y, costs and duration of hospitalization. We reviewed 1021 patients who und erwent cesarean section (597 elective, 424 emergency) and 814 gynecological patients undergoing abdominal (373) or Vaginal (248) hysterectomy and myom ectomy (193) between 1997-98 in the Obstetrics and Gynecology Clinic of the University of Florence. Before surgery 83.6% of obstetric and 75.1% of gyn ecological patients received 1 or 2 g of a first or second generation cepha losporin i.v. as a single-dose regimen at induction of anesthesia and somet imes a second postoperative dose. 1.5% of obstetric surgical patients had w ound infection, as did 2.8% of gynecological surgery patients, with a mean postoperative hospital stay of 8 days, The short-term perioperative antimic robial prophylaxis with cephalosporins is useful and provides the benefit o f minimal toxicity and risk of chemoresistance.