Patient costs for prophylaxis and treatment of obstetric and gynecologic surgical infections.

The use of newer broad-spectrum antimicrobials for prophylaxis and treatment in obstetric and gynecologic surgery can reduce patient morbidity and hospital costs. For prophylaxis, a single dose of a cephalosporin with a long elimination half-life can be as effective as a more prolonged course. Single-dose prophylaxis reduces not only toxicity and cost to the patient but also the likelihood of colonization of the vagina by resistant organisms. Treatment regimens for postoperative pelvic infections should have broad-spectrum coverage against aerobic and anaerobic pathogens to ensure high cure rates and prevent subsequent abscess formation. With the introduction of newer cephalosporins and penicillin combinations that include a beta-lactamase inhibitor, it is now possible to treat these polymicrobial infections effectively with monotherapy. Compared with traditional antibiotic combinations, these drugs can reduce side effects and the costs of drug administration as well as the need for therapeutic monitoring. The use of oral antibiotics to complete a course of treatment can also help decrease the high costs of parenteral antibiotic therapy and hospitalization.