The aim of this study was to compare efficacy and safety of perioperative antibiotic prophylaxis in patients undergoing abdominal or vaginal hysterectomy or gynaecological laparotomy to im prove the prevention of surgical wound infections. One hundred and ninety-nine patients were prospectively randomized into two groups: the first group (n = 100) received perioperative prophylaxis using 1 g cefotiam (Spizef(R)) and 0.5 g metronidazole (Clont(R)) intravenously 30 min before surgery, whereas the second group (n = 99) was treated with 2 g cefoxitin (Mefoxitin(R)) intravenously, also 30 min before surgery. The efficacy of the perioperative antibiotic prophylaxis was assessed clinically and on the basis of laboratory parameters. No wound infections were observed in 97 patients (97%) of the cefotiam-treated group and in 94 patients (94%) of the cefoxirin-treated group. No systemic postoperative infections were observed in 81% of the patients treated with cefotiam combined with metronidazole and in 85% of the patients treated with cefoxitin. The good tolerability of the drugs administered was proven in 98% of the patients treated with cefotiam and metronidazole and in 97% of the patients treated with cefoxitin. In both groups 3 patients developed nausea and/or vomiting, respectively, due to the antibiotic prophylaxis. A low infection rate after gynaecological surgery was observed. Cefotiam as a low dosage combined with metronidazole was as effective as cefoxitin. Cephalosporins of the second generation in combination with metronidazole can, therefore, be considered effective and safe drugs in the prevention of postsurgical infections. Copyright (C) 2001 S. Karger AG,Basel.

Ziel der vorliegenden Untersuchung war es, die Wirksamkeit und Verträglichkeit zweier Zephalosporine in der perioperativen Antibiotikaprophylaxe bei Patientinnen, die einer abdominalen oder vaginalen Hysterektomie oder einer gynäkologischen Laparotomie unterzogen wurden, zu testen, um die Rate postoperativer Störungen der Wundheilung zu verringern. Insgesamt wurden 199 Patientinnen prospektiv in zwei Gruppen randomisiert. Die erste Gruppe (n = 100) erhielt perioperativ 1 g Cefotiam (Spizef®) und 0,5 g Metronidazol (Clont®) intravenös 30 min vor der Operation, während die zweite Gruppe (n = 99) 2 g Cefoxitin (Mefoxitin®) intravenös erhielt, ebenfalls 30 min vor der Operation. Die Wirksamkeit der Prophylaxe wurde sowohl klinisch als auch aufgrund von laborchemischen Parametern objektiviert. Bei 97 Patientinnen (97%) der Cefotiam-Gruppe und bei 94 Patientinnen (94%) der Cefoxitin-Gruppe traten keine Wundheilungsstörungen auf. Keine postoperativen systemischen Infektionen wurden bei 81% der Cefotiam-Gruppe und 85% der Cefoxitin-Gruppe beobachtet. 98% der Patientinnen der Cefotiam-Gruppe und 97% der Patientinnen der Cefoxitin-Gruppe wiesen eine sehr gute bzw. gute Verträglichkeit der Medikation auf. In beiden Gruppen traten, durch die Antibiotikaprophylaxe bedingt, jeweils nur bei 3 Patientinnen Übelkeit bzw. Erbrechen auf. Die Untersuchung ergab im gesamten Kollektiv sehr niedrige Infektionsraten. Cefotiam in niedriger Dosierung und Metronidazol waren genauso wirksam wie Cefoxitin. Zephalosporine der zweiten Generation in Kombination mit Metronidazol können daher als sehr wirksame und nebenwirkungsarme Antibiotika bei der Prophylaxe lokaler Infektionen angesehen werden.

The rare case of a decidualized endometriosis of the appendix vermiformis is reported in a woman who developed HELLP syndrome during the 32nd week of a twin pregnancy. Cesarean section and simultaneous appendectomy were performed. An inspection of the appendix should always be carried out if an endometriosis-associated anamnesis is known. No pathophysiological correlations between the HELLP syndrome and the endometriosis of the appendix vermiformis could be found.

The rare case of a decidualized endometriosis of the appendix vermiformis is reported in a woman who developed HELLP syndrome during the 32nd week of a twin pregnancy. Cesarean section and simultaneous appendectomy were performed. An inspection of the appendix should always be carried out if an endometriosis-associated anamnesis is known. No pathophysiological correlations between the HELLP syndrome and the endometriosis of the appendix vermiformis could be found.

The rare case of a decidualized endometriosis of the appendix vermiformis is reported in a woman who developed HELLP syndrome during the 32nd week of a twin pregnancy. Cesarean section and simultaneous appendectomy were performed. An inspection of the appendix should always be carried out if an endometriosis-associated anamnesis is known. No pathophysiological correlations between the HELLP syndrome and the endometriosis of the appendix vermiformis could be found.