Summary:
A prospective study was done in the Department of Obstetrics
& Gynaecology, BSMMU, Dhaka from January 2006 to
December 2006. Hundred cases were studied during this
period. The patients admitted for hysterectomy operation were
divided into group A and group B. In group A 50 patients
received prophylactic injectable 1 gm ceftriaxone, 500 mg
metronidazole and 80 mg gentamicine one hour before
operation. In group B 50 patients received conventional
antibiotic comprising ciprofloxacin for 7 days (both I.V and
Oral), metronidazole for 5 days (both I.V and oral) and
gentamicine for 3 days (I.V / I.M). After fulfilling the inclusion
and exclusion criteria the patients were randomly assigned
to receive either parenteral loading dose of 1 gm Ceftriaxone,
500 mg Metronidazole and 80 mg Gentamicine (Group-A)
pre-operatively or conventional dose of antibiotic (Group-
B). Relevant careful clinical records and data were kept on
predesigned proforma. Incidence of post-operative
complications, operative time and hospital stay were recorded
for each patient. Data was analyzed using SPSS program
with the consultation of the statistician. Because of nature of
the analysis, only chi-squire(X2) test was applied. Most of
the patients (64% in Group-A and 67% in Group-B) were
from low socio-economic class. Significant number of patients
were anaemic (Hb% between 50-55%) and duration of
operation was within 60-89 minutes in most of the cases.
There were 3(6%) post operative wound infection in Group-
A and 2(4%) post operative wound infection in Group-B after
abdominal hysterectomy. 1 patient of Group-A and 1 patient
of Group-B developed wound infection after vaginal
hysterectomy operation. So, there was no significant
difference in post-operative wound infection between Group-
A and Group-B. Length of post-operative hospital stays in
both groups were within 5-9 days (Group-A 90% and Group-
B 92%). The study demonstrates that there is no significant
difference regarding surgical outcome between Group-A and
Group-B. Moreover the patient of Group-A needs antibiotic
cost only Tk. 220 and Group-B needs of about Tk. 640, so
that it saves about Tk. 420 which supports the economic
benefits for Group-A and cost effectiveness.
Key Words: Hysterectomy, Antibiotics, Parenteral,
Prohpylaxis, Conventional