A randomized controlled trial comparing ceftriaxone with cefazolin for antibiotic prophylaxis in abdominal hysterectomy

OBJECTIVE: To compare the effectiveness of ceftriaxone versus cefazolin for the prevention of febrile morbidity and postoperative infections among patients after abdominal hysterectomy. METHODS: In a double-blind, randomized, controlled trial in Bangkok, Thailand, 320 patients undergoing abdominal hysterectomy between July 2008 and July 2009 were randomly assigned to receive 1g of either ceftriaxone or cefazolin intravenously in a single dose before surgery. The participants were evaluated for postoperative fever and infection for up to 4 weeks. χ(2) or Fisher exact tests were used for statistical analysis. RESULTS: There was no significant difference between the ceftriaxone and cefazolin groups in incidence of febrile morbidity (9.4% versus 11.2%), wound infection (3.8% versus 1.9%), vaginal cuff infection (3.8% versus 1.9%), or urinary tract infection (1.9% versus 1.9%). CONCLUSION: There was no difference between the use of single-dose preoperative ceftriaxone and cefazolin in preventing infectious morbidity among patients undergoing hysterectomy.