Prophylactic Metronidazole or Suction Drainage in Abdominal Hysterectomy

The efficacy of a two-dose perioperative course of oral metronidazole or suction drainage of the vaginal vault was evaluated in a randomized study of 150 patients undergoing abdominal hysterectomy. Patients receiving metronidazole demonstrated a significant reduction in febrile morbidity (from 48 to 8%), infectious morbidity (from 46 to 16%), urinary tract infections (from 30 to 10%), and pelvic and/or abdominal wound infections (from 18 to 2%). The patients managed with suction drainage showed a marked reduction in febrile and infectious morbidity; however, this reduction was not significant. Overall, 17% of all specific postoperative infections were first diagnosed after discharge from the hospital. No adverse side effects of metronidazole were encountered.