腟式あるいは腹式子宮全剔術後の感染に対する抗生物質の予防効果Febrile morbidity及びFever indexによる検討

抄録

The current references written in English concerning effect of prophylactic antibiotics in vaginal and abdominal simple hysterectomy have been reviewed.
Febrile morbidity was evaluated for antibiotic treated and untreated groups.In most studies, the definition of febrile morbidity was a temperature of 38°Cor greater on 2 separate occations excluding the first 24hours after the operation.Fever index in degree hours was also compared between 2 groups in some studies.
Of 30 studies in vaginal hysterectomy reported between 1969 and 1981, 29 showed that antibiotic prophylaxis successfully decreased postoperative febrile morbidity.Of 15 studies in abdominal hysterectomy reported between 1972 and 1982, 12 showed the significant decrease of febrile morbidity in the treated group.However, pelvic infection in only 2 and wound infection in 5 were reduced.The length of hospital stay was found to be shorter for the treated group in vaginal and abdominal hysterectomy. The beneficial effect of prophylactic antibiotics in abdominal hysterectomy were less compelling than those for vaginal hysterectomy.
Although recent studies indicated that a short perioperative use of antibiotics or even a single dose was effective as long-term prophylaxis, the most effective method and duration awaits further evaluation.