CEFUROXIME AND METRONIDAZOLE IN GYNAECOLOGICAL SURGERY

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Abstract
The predominant potential pathogensin the vaginal flora, sampled before operation in 41 patients undergoing gynecological surgery, included Escherichia coli, .alpha.-hemolytic streptococci, Streptococcus faecalis, anaerobic gram-positive cocci and Bacteroides fragilis. All the aerobic gram-negative bacilli and 89.7% of the streptococci isolated were sensitive to 4 .mu.g/ml of cefuroxime. Most of the anaerobes were very sensitive to cefuroxime, although the minimum inhibitory concentration (MIC) for 52% of B. fragilis isolates was at least 8 .mu.g/ml. The MIC of metronidazole was < 1 .mu.g/ml for almost all anaerobes. All patients were given 1 g of metronidazole by suppository on the night before operation and a second suppository was given, together with 750 mg of cefuroxime injected i.m. with the premedication. The mean extravascular tissue concentrations of cefuroxime and metronidazole, assayed in 29 patients, were, respectively, 8.9 and 8.0 .mu.g/g (uterus), 14.2 and 22.2 .mu.g/g (cervix), 13.1 and 6.3 .mu.g/g (Fallopian tube), 12.3 and 2.1 .mu.g/g (ovary), 10.3 and 12.4 .mu.g/g (vagina), 13.3 and 13.7 .mu.g/ml (serum), 3570.0 and 122.3 .mu.g/ml (urine). None of the patients developed post-operative wound infections or adverse reactions.

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