Antibiotic prophylaxis in vaginal hysterectomy: a review.

Recent experimental studies in laboratory animals have elucidated the pathogenesis of operative site infections and have defined the mechanism by which prophylactic antibiotics enhance host defenses against infection. On the basis of these experimental observations, several investigators have conducted well-designed studies to evaluate the effectiveness of prophylactic antibiotics in reducing the risk of infection associated with vaginal hysterectomy. Without exception, these studies have demonstrated a dramatic decrease in the incidence of pelvic infections when antimicrobial agents are administered for a limited time in the perioperative period. To date, short courses of prophylactic antibiotics have not been shown to create selective pressures for the emergence of drug-resistant organisms or to lead to the development of more serious superinfections.