PID26: PHARMACOECONOMIC EVALUATION OF CEFUROXIME IN ABDOMINAL HYSTERECTOMY

Abstract

OBJECTIVES: The prophylaxis of infection in hysterectomy is necessary because it decreases the amount of postoperative complications. It has been shown that cefuroxime is an effective antibiotic for prevention of infectious complications after abdominal hysterectomy. It has a bactericidal activity against most pathogens which can lead to wound failure and prolonged the duration of hospitalization. But pharmacoeconomic evaluation is not performed in the numerous investigations. METHODS: 40 women were randomized in equal groups to receive cefuroxime 1,5 g i.v. before start of hysterectomy (group I) and combination of ampicillin 4,0 g/day i.m. and gentamycin 5 mg/kg/day i.m. during 5 days after hysterectomy (group II). The last method is commonly used in city gynecological departments. General condition, temperature, pulse, condition of postoperative wounds, vaginal discharges were evaluated every day by means of a score scale. The sum of scores was performed as total clinical score (TCS). Cost-minimization analysis was performed for evaluation of economic outcomes of the treatment. RESULTS: Clinical efficacy of the studied regimens was equal because the dynamic of TCS coincided in both groups (100% and 95% accordingly). Condition of wounds was excellent and pathogenic microorganisms were not performed. But in group II were detected skin rash (3 cases) and infectious infiltrate in the place of injection (1 case). Duration of hospitalization was similar in both groups. But total cost in group I was less by 17.7% than in group II (p < 0.05) because acquisition cost was more in group II. CONCLUSIONS: Prophylaxis of infectious complications in hysterectomy by cefuroxime is as effective as combination postoperative treatment with ampicillin plus gentamycin. Cefuroxime has an economic advantage and less danger for patients. This simple method of prophylaxis indicates more compliance and less cost and may be recommended for most cases of hysterectomy.