Cefuroxime prophylaxis in caesarean section.

A double-blind, randomized prospective study was carried out in 96 women in labour requiring caesarean section to assess the value of antibiotic prophylaxis with cefuroxime compared with placebo. Forty-six patients received 750 mg cefuroxime intravenously before and every 8 hours for the first 72-hours post-operatively; the other 50 women received placebo injections. A significant decrease in post-operative morbidity was observed in the drug-treated group, there were far fewer endometrial, urinary and pulmonary injections, and those who received prophylactic cefuroxime had less days of hospitalization than the placebo-treated group. No serious side-effects were observed.

Bacteriologic aspects of pelvic inflammatory disease in gynecologic patients.

The bacteriology of acute pelvic inflammatory disease (PID) was studied in 65 women. Endometrial, endocervical and vaginal cuff cultures were taken. In some cases blood cultures and cultures from the cul-de-sac or pelvic abscess were also obtained. Mixed organisms (aerobes and anaerobes) were the most common isolates from the endometrial, endocervical or vaginal cuff cultures, present in 40%. Neiseria gonorrhoeae was isolated in 8 (12.30%) endocervical specimens. Anaerobes were the most common bacteria recovered from cul-de-sac aspirates, pelvic abscesses and blood cultures. The combination of gentamicin, penicillin and metronidazole was the most common antibiotic scheme used. However, other antibiotics as cefoxitin and clindamycin were also used according to the sensitivity test. These data support the polymicrobial etiology of the disease and suggest: (1) the high incidence of anaerobic or mixed infections, and (2) the relatively low incidence of gonococcus in the studied cases.

E. coli growth inhibition by amniotic fluid.

Amniotic fluid samples were collected aseptically from 29 normal pregnancies, between the 38th and 41st week of gestation and checked for sterility in the laboratory, in order to investigate in vitro the effect of the liquor on the growth of E. coli. Brain Heart Infusion (B.H.I.) and Ringer solution were used as controls. E. coli cultures were inoculated in amniotic fluid, B.H.I., Ringer solution and amniotic fluid plus B.H.I. and incubated at 37degreesC for 48 hours. At 0, 1, 3, 6, 12, 24, 36 and 48 hours of incubation, surface viable counts were performed to estimate the number of E. coli viable cells. The growth of E. coli in B.H.I. started furing the 1st hours after inoculation and continued over 48 hours; in Ringer solution the mean growth curve and almost identical to that of B.H.I. In amniotic fluid the growth of E. coli began from the 1st hour of inoculation but the growth curve was much lower, became static in 24 hours and a permanent inhibition was observed thereafter. The addition of a small amount of B.H.I. in amniotic fluid enhanced the growth of E. coli, but the growth curve was lower in comparison to the curves of the two controls studied. In conclusion, after 48 hours of inoculation in amniotic fluid, 26 of the 29 cases showed bacteriostatic or bactericidal activity of the liquor upon the growth of E. coli.