Single-dose cefamandole and cefotaxime prophylaxis at vaginal and abdominal hysterectomy

Two hundred forty-one women were randomly given 1 g of either cefamandole or cefotaxime intravenously in the operating room prior to vaginal or abdominal hysterectomy in a prospective, blinded clinical trial of antimicrobial prophylaxis. Eight of 163 women (4.9%) developed operative site infection requiring parenteral antimicrobial therapy after abdominal hysterectomy, as did 2 of 78 women (2.6%) after vaginal hysterectomy, without significant interregimen differences. Five of 8 (62.5%) infections that developed after abdominal hysterectomy followed patients' discharge from the hospital. There were many significant interprocedure, but not interregimen, differences in demographic, surgical, and outcome variables - confirming benefits for women when vaginal hysterectomy is possible.