Antibiotic prophylaxis for selected gynecologic surgeries.

Department of Obstetrics and Gynecology, Kaiser Medical Center San Francisco, San Francisco, USA.

International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 2013 Jan

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Antibiotic prophylaxis for surgery is commonly used and is recommended by multiple organizations. To critically review gynecology-specific data regarding surgical antibiotic prophylaxis in selected benign gynecologic surgeries. MEDLINE and Cochrane databases were searched from inception to July 2010. Randomized controlled trials of benign vaginal, cervical, transcervical, abdominal, or laparoscopic procedures other than hysterectomy comparing prophylactic antibiotic use with placebo or with another antibiotic. Outcomes of interest were postoperative infections, additional treatments, and adverse events. In total, 19 trials met the inclusion criteria. Studies were individually assessed for methodologic quality, then grouped by procedure and evaluated for evidence quality. There was no difference in infectious outcome for loop electrosurgical excision, hysteroscopic ablation, or laparoscopy, although evidence quality was poor. Fair evidence supports antibiotic prophylaxis for suction curettage or laparotomy. There were insufficient data regarding vaginal surgery prophylaxis. Antibiotic prophylaxis may be beneficial in first-trimester suction curettage and laparotomy. No advantage was found for loop electrosurgical excision, hysteroscopy, or laparoscopic gynecologic surgery. Newer procedures and vaginal surgery lack research and merit study. Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Citation

Michelle Y Morrill, Megan O Schimpf, Husam Abed, Cassandra Carberry, Rebecca U Margulies, Amanda B White, Lior Lowenstein, Renée M Ward, Ethan M Balk, Katrin Uhlig, Vivian W Sung, Society of Gynecologic Surgeons Systematic Review Group. Antibiotic prophylaxis for selected gynecologic surgeries. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics. 2013 Jan;120(1):10-5