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Cost‐benefit analysis of cephradine and mezlocillin prophylaxis for abdominal and vaginal hysterectomy
Author(s) -
DAVEY PETER G.,
DUNCAN IAN D.,
EDWARD DOREEN,
SCOTT ARCHIE C.
Publication year - 1988
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.1988.tb06796.x
Subject(s) - cephradine , mezlocillin , medicine , abdominal hysterectomy , hysterectomy , placebo , surgery , gynecology , antibiotics , genetics , alternative medicine , pathology , bacteria , cephalosporin , microbiology and biotechnology , pseudomonas aeruginosa , biology , piperacillin
Summary. Four hundred patients (300 abdominal and 100 vaginal hysterectomies) were randomized to receive a single, pre‐operative intravenous injection of saline (placebo), 2 g cephradine or 5 g mezlocillin. The frequency of wound and pelvic infections was significantly reduced (P<0.05, χ 2 ‐ or Fisher's exact test) in the abdominal hysterectomy patients who received cephradine (16% vs 23% mezlocillin, 29% placebo) and in the vaginal hysterectomy patients who received cephradine or mezlocillin (0% mezlocillin, 6% cephradine vs 27% placebo). These results are similar to those of previous studies and suggest that prophylaxis is more effective for vaginal than for abdominal hysterectomy. However, a cost‐benefit analysis supported the opposite conclusion. Cephradine prophylaxis for abdominal hysterectomy resulted in cost savings to the hospital and the community health services with measurable benefits to the patient. In contrast, cephradine or mezlocillin prophylaxis for vaginal hysterectomy resulted in increased costs to the hospital, no savings to community services and no significant benefit to the patient. We conclude that cost‐benefit analysis provided valuable additional information to the conventional, statistical analysis of wound or pelvic infection rates.