Table 1. Characteristics of Randomized Controlled Studies Included in the Meta-analysis Prophylactic antimicrobials


Study (First Author, Year)


Study Period Study Setting


Baldoni, 198917 ? Prior to 1989 Italy, university setting, multicenter


Chongsomchai, 200236


1997–1999 Cormio, 200320 1999–2002


Grossman, 197921


1975–1977


Thailand, university setting


Hysterectomy Type


Abdominal and vaginal


Abdominal


Italy, university setting Abdominal and vaginal


US, university setting Abdominal and vaginal


Hemsell, 198437 1982–1983


US, university setting, multicenter


Hemsell, 198538 1982–1983 US, university setting Hemsell, 198739 1983–1985 US, university setting Vaginal Study Population


Surgery for benign indications (n=78); endometrial carcinoma (n=2); median surgery duration: 50–60 min


Surgery for benign indications mostly; 10% patients with CIN (n=22)


Surgery for benign indications only


Indications for surgery not specified


Indications for surgery not specified


Abdominal and vaginal


Vaginal


Indications for surgery not specified


Surgery for benign indications mostly; included women with CIN


Hemsell, 199522 1989–1992 Jyothi, 201024 Periti, 198818 Periti, 198819


Phoolcharoen, 201225


Stiver, 199023 2004–2005 1988 US, university setting Abdominal India,


governmental hospital in rural setting


Italy,


university setting, multicenter


? Prior to 1988 Italy, university setting, multicenter


2008–2009 Thailand, university setting ? Prior to 1990 Canada, university setting Vaginal


Abdominal and vaginal


Abdominal and vaginal


Abdominal and vaginal


Abdominal


Surgery for benign indications only


Surgery for benign indications only


Included 17% of patients with neoplastic disease


Included 15%–18% patients with neoplastic disease


Excluded patients with suspected gynecological malignancies; excluded patients with immune compromise


Cefazolin


Cefazolin 1 g IV × 3 doses


Cefazolin 1 g IV once


Cefazolinb 2 g IV once


Cefazolin 500mg IV on call to OR and every 6 h × 48 h


Cefazolin 1 g IM once, then 1 g IV × 2 doses postop


Cefazolin 1 g IM once, then 1 g IV × 2 doses postop


Cefazolin 1 g IM once 2 g IM once


Cefazolin 1 g IV once


Cefazolinc 2 g IV once


Cefazolin 2 g IV × 2 doses


Cefazolin 2 g IV × 2 doses


Cefazolin 1 g IV once


Included 7 patients with neoplasia Cefazolin 1 g IV × 4 doses


Comparator


Cefotetan 2 g IV once


Ampicillin 1 g IV once


Amoxacillin-clavulanateb 2.2 g IV once


Penicillin G 1 million units IV on call to OR and every 6h×48h


Ceftriaxone 1 g IM once, placebo IV × 2 doses postop


Ceftriaxone 1 g IM once, placebo IV × 2 doses postop


Cefoxitin 2 g IM once Cefotaxime 1 g IM once


Cefotetan 1 g IV once


Amoxicillin-clavulanatec 2.4 g IV once


Cefotetan 2 g IV once


Cefotaxime 2 g IV once


Ceftriaxone 1 g IV once


Ceftriaxone 1 g IV once


Clinical Outcomea


Surgical wound infection; vaginal cuff infection


Surgical wound infection; vaginal cuff infection


Surgical wound infection


Surgical wound infection; postoperative vaginal wound infection; vaginal cuff infection


Infected pelvic abscess or hematoma; vaginal surgical margin infection


Wound infection; infected pelvic abscess or hematoma


Pelvic infection requiring parenteral antimicrobial therapy


Infected pelvic hematoma; pelvic abscess; abdominal wound infection


Abdominal wound infection; vaginal cuff infection


Any surgical wound that drained purulent or serous material, together with or without positive cultures


Any surgical wound that drained purulent or serous material, with or without positive cultures


Wound infection; vaginal cuff infection


Pelvic infection, defined as fever plus 1 or more: purulent drainage from the vaginal cuff, abdominal pain with rebound tenderness or guarding, localized tenderness with tender adnexal mass on bimanual palpation, or bacteremia with or without hypotension


Note. IV, intravenous, IM, intramuscular; CIN, cervical intraepithelial neoplasia; OR, operating room; postop, postoperatively. aDefined as surgical site infection (SSI) in our study. bAntimicrobial redosed for extensive blood loss (>1,500 mL) or surgery duration>3h. cAntimicrobial redosed for extensive blood loss (>1,000 mL) or surgery duration>3h.


Infection Control & Hospital Epidemiology


145


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