P.C. Gunasekera

Obstetrics and gynaecology in the developing world

Sir, Olsson et al. (Vol 103, April 1996) report an interesting study comparing laparoscopic hysterectomy to the abdominal approach. The total abdominal hysterectomy group did not receive prophylactic antibiotic cover and were subsequently found to have a higher frequency of infectious morbidity although this was not statistically significant. A meta-analysis of randomised trials of antibiotic prophylaxis has clearly shown that it is highly effective in preventing infections associated with total abdominal hysterectomy and concludes that the use of controls who receive no treatment is no longer justified2. We were therefore puzzled to note that the total abdominal hysterectomy group in the trial by Olsson et al. had not been given any prophylactic antibiotic.