Benefits , harms , and costs Guideline implementation should result in a reduction of cost and related harm of administering antibiotics when not required and a reduction of infection and related morbidities when antibiotics have demonstrated a proven benefit .
Abstract Objective To review the evidence and provide recommendations on antibiotic prophylaxis for gynaecologic procedures .
Outcomes Outcomes evaluated include need and effectiveness of antibiotics to prevent infections in gynaecologic procedures .
A Randomized Trial of Prophylactic Doxycycline for Curettage in Incomplete Abortion
Objective To determine whether prophylactic doxycycline at suction curettage for incomplete abortion decreases the rate of postoperative pelvic infection . Methods We r and omized 240 patients to receive intravenous doxycycline or placebo at curettage . Cervical specimens for gonorrhea and chlamydia were obtained preoperatively . Two weeks post-procedure , we evaluated all patients for infectious morbidity and repeated gonorrhea and chlamydia cultures . Statistical analysis used Mann-Whitney U test , McNemar test , or Fisher exact test , as appropriate . Results There were no statistically significant differences in age , parity , gestational age , history of sexually transmitted disease , pelvic inflammatory disease , or multiple sex partners between the doxycycline and placebo groups . Preoperative gonorrhea or chlamydia isolates were positive in five ( 4.2 % ) and six ( 5 % ) of 120 doxycycline patients and four ( 3.3 % ) and eight ( 6.6 % ) of 120 controls ( not significant ) . All preoperative gonorrhea isolates remained positive postoperatively . Seven ( 5.8 % ) controls had positive postoperative chlamydia isolates , as did one ( 0.8 % ) in the doxycycline group ( P = .06 ) . We diagnosed eight ( 6.6 % ) of 120 doxycycline patients and seven ( 5.8 % ) of 120 controls with infectious morbidity ( not significant ) . Conclusion In our population of patients with incomplete abortion , the prevalence of gonorrhea and chlamydia was low , and prophylactic doxycycline did not decrease the rate of postoperative febrile morbidity
Benefits , harms , and costs Guideline implementation should result in a reduction of cost and related harm of administering antibiotics when not required and a reduction of infection and related morbidities when antibiotics have demonstrated a proven benefit .
Abstract Objective To review the evidence and provide recommendations on antibiotic prophylaxis for gynaecologic procedures .
Outcomes Outcomes evaluated include need and effectiveness of antibiotics to prevent infections in gynaecologic procedures .