Antibiotic prophylaxis for selected gynecologic surgeries

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

Research output: Contribution to journalReview article

25 Scopus citations

Abstract

Background: Antibiotic prophylaxis for surgery is commonly used and is recommended by multiple organizations. Objective: To critically review gynecology-specific data regarding surgical antibiotic prophylaxis in selected benign gynecologic surgeries. Search strategy: MEDLINE and Cochrane databases were searched from inception to July 2010. Selection criteria: 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. Data collection and analysis: In total, 19 trials met the inclusion criteria. Studies were individually assessed for methodologic quality, then grouped by procedure and evaluated for evidence quality. Main results: 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. Conclusion: 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.

Original languageEnglish (US)
Pages (from-to)10-15
Number of pages6
JournalInternational Journal of Gynecology and Obstetrics
Volume120
Issue number1
DOIs
StatePublished - Jan 2013

Keywords

  • Antibiotics
  • Gynecologic surgery
  • Prophylaxis

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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    Morrill, M. Y., Schimpf, M. O., Abed, H., Carberry, C., Margulies, R. U., White, A. B., Lowenstein, L., Ward, R. M., Balk, E. M., Uhlig, K., & Sung, V. W. (2013). Antibiotic prophylaxis for selected gynecologic surgeries. International Journal of Gynecology and Obstetrics, 120(1), 10-15. https://doi.org/10.1016/j.ijgo.2012.06.023