Antibiotic prophylaxis for hysterectomy and cesarean section: Amoxicillin-clavulanic acid versus cefazolin

Objective: To compare amoxycillin-clavulanic acid with cefazolin as short term antibiotic prophylaxis in women undergoing hysterectomy and elective cesarean section. Method: Sixty women undergoing hysterectomy were randomly assigned either to 2.4g intravenous amoxycillin-clavulanic acid (AMX/CL) or 2g cefazolin 30 min before hysterectomy. One hundred and twenty two women delivered by elective cesarean were randomized to a single dose of either of the above antibiotics at cord clamping. Each patient was assessed daily until discharge for evidence of febrile status and the presence of infection at the operative site and urinary tract. Results: Infectious morbidity was found in 11% and 12.5% of hysterectomy patients inAMX/CL and cefazolin groups respectively. Ten women had post-cesarean infections (sixAMXCL, four cefazolin, P=0.51) Conclusion: Broad spectrum amoxycillin-clavulanic acid was not superior to cefazolin in the prevention of postoperative infection when given as prophylaxis in hysterectomy and elective cesarean cases.