Does Pre‐ and Postoperative Metronidazole Treatment LowerVaginal Cuff Infection Rate After Abdominal HysterectomyAmong Women With Bacterial Vaginosis?

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Abstract
Objective: Bacterial vaginosis (BV) is a known risk factor for postoperative infection following abdominal hysterectomy. Vaginal bacterial flora scored as intermediate has been shown to have the same risk of postoperative infection as BV.Methods: Women undergoing total abdominal hysterectomy for benign diseases were open‐randomized according to Zelen to either treatmentwith metronidazole rectally for at least 4 days or no treatment. At the preoperative gynecological examination a vaginal smear was collected and Gram stained. Women with BV or intermediate flora were merged to one group called abnormal vaginal flora.Results: In total 213 women were randomized to treatment or no treatment. After exclusion of 71 women, 142 women were eligible for analysis. Among the 59 women diagnosed with abnormal vaginal flora there were no vaginal cuff infections in the treated arm, comparedwith 27% in the ‘no treatment’ arm (p Conclusion: Pre‐ and postoperative treatment for at least 4 days with metronidazole rectally reduces significantly vaginal cuff infection among women with abnormal vaginal flora.
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  • Central Hospital of Skövde