Antibiotic prophylaxis for selected gynecologic surgeries

Morrill, Michelle Y.; Schimpf, Megan O.; Abed, Husam; Carberry, Cassandra; Margulies, Rebecca U.; White, Amanda B.; Löwenstein, Lior; Ward, Renée M; Balk, Ethan M; Uhlig, Katrin; Sung, Vivian W.

doi:10.1016/j.ijgo.2012.06.023

Cited by 45 publications

(19 citation statements)

References 30 publications

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“…ciprofloxacin) can be used. Laparoscopic operations not contaminated by the genitourinary or digestive tracts do not require antimicrobial prophylaxis [58].…”

Section: Antimicrobial Prophylaxis and Skin Preparationmentioning

confidence: 99%

Guidelines for pre- and intra-operative care in gynecologic/oncology surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations — Part I

Nelson¹,

Altman

Nick

et al. 2016

Gynecologic Oncology

396

252

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“…ciprofloxacin) can be used. Laparoscopic operations not contaminated by the genitourinary or digestive tracts do not require antimicrobial prophylaxis [58].…”

Section: Antimicrobial Prophylaxis and Skin Preparationmentioning

confidence: 99%

Guidelines for pre- and intra-operative care in gynecologic/oncology surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations — Part I

Nelson¹,

Altman

Nick

et al. 2016

Gynecologic Oncology

396

252

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“…[18] Moreover, 3 systematic reviews summarizing relative antibiotic prophylaxis for gynecologic procedures without quantitative analysis failed to provide clinical options and failed to reach consistent conclusions. [19–21] Therefore, the current study was the first quantitative meta-analysis in this field, and we demonstrated that antibiotic prophylaxis is not necessary for hysteroscopic procedures. And all included trails were performed in the last decade which made the raw data meet the needs of today.…”

Section: Discussionmentioning

confidence: 65%

The clinical effects of antibiotic prophylaxis for hysteroscopic procedures

et al. 2019

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Background: Hysteroscopic procedures were widely applied but the clinical effects of antibiotic prophylaxis for these operations were not specifically addressed. In current study, we aimed to investigate the role of prophylactic antibiotics in hysteroscopic procedures by meta-analysis. Methods: We conducted literature retrieval in electronic databases, including MEDLINE, EMBASE, and Cochrane Central, to identify relevant randomized controlled trials (RCTs) investigating the clinical effects of antibiotic prophylaxis for hysteroscopic procedures. The postoperative infection rate was selected for pooled estimation. The I 2 index statistic was used to assess heterogeneity. Publication bias was evaluated using funnel plots and Egger test. Sensitivity analysis based on different subcategories was conducted to examine the stability of the main results. Results: Four RCTs including 2221 patients were identified for the final quantitative analysis. Pooled estimation indicated no significant difference in infection rate between the antibiotic prophylaxis group and control group (test for OR: Z = 0.50, P = .616; 95% CI: 0.987–1.008). Sensitivity analysis based on surgical procedure, antibiotic application, follow-up time and administration time revealed similar results. Conclusion: Based on current objective evidence, we conclude that antibiotic prophylaxis exhibits no clinical benefit for hysteroscopic procedures. Therefore, it is not recommended. Meanwhile, more high-quality RCTs are needed to support our conclusion.

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“…Our interest is on hysteroscopy. To answer this question, Morrill et al [15] refer in their review to Bhattacharya et al [14]. No other new articles on prophylactic antibiotics in hysteroscopy were included.…”

Section: Resultsmentioning

confidence: 99%

Prophylactic Antibiotic Treatment during Hysteroscopy: A Systematic Review

Wijma¹,

Linden²

2015

OJOG

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Background: Overall, the use of antibiotics is increasing. We noticed different practices amongst different hospitals in their prophylactic use of antibiotics during operative hysteroscopy. This review investigates whether there is sufficient evidence to recommend antibiotic prophylaxis in operative hysteroscopy. Methods: We performed a systematic search in "Pubmed" using "hysteroscopy" and "antibiotic" and "prophylaxis" as search items. We found 16 hits of which 4 were suitable to include in our review. Findings: In an included Cochrane review no conclusion was drawn since no articles could be included. A prospective study by Nappi et al.[1] support the recommendation of the American College of Obstetricians and Gynaecologists not to prescribe routinely antibiotic prophylaxis in cases of hysteroscopic surgery. Bhattacharya et al. conducted a prospective study that was ended prematurely. They conclude that there is no convincing evidence that prophylactic antibiotics are of value in hysteroscopy. A review by Morrill et al. yielded no new data. Conclusion: We did not find a significant increase in clinical relevant infectious symptoms after hysteroscopy in women treated with or without antibiotic prophylaxis, although data are insufficient to draw a definite conclusion. Therefore, we suggest a prospective study is mandatory on this topic.

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Antibiotic prophylaxis for selected gynecologic surgeries

Abstract: 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.

Cited by 45 publications

References 30 publications

Guidelines for pre- and intra-operative care in gynecologic/oncology surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations — Part I

Guidelines for pre- and intra-operative care in gynecologic/oncology surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations — Part I

The clinical effects of antibiotic prophylaxis for hysteroscopic procedures

Prophylactic Antibiotic Treatment during Hysteroscopy: A Systematic Review

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