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 .
Metronidazole Prophylaxis in Elective First Trimester Abortion
In a double-blind controlled trial , the efficacy of prophylactic metronidazole in  elective first trimester abortions  was assessed . Of 119 r and omized women , 100 followed the protocol . Fifty-one women received 400 mg metronidazole one hour before and again four and eight hours after abortion ; 49 women received a placebo . In the placebo group 20.4 % contracted postabortal genital infection compared with 3.9 % in the metronidazole group ( P<.025 ) . Of 25 women with a positive history of pelvic inflammatory disease , six contracted postabortal infection , which was a significantly increased frequency compared with women without previous episodes of pelvic inflammatory disease ( P<.05 ) . The administration of prophylaxis , however , did not significantly influence the frequency . The number of hospital days was not significantly lower in the prophylaxis group ( P>.05 ) . The total amount of metronidazole  prescribed in the study group was significantly larger than in the placebo group ( P<.05 ) , whereas the amount of  ampicillin/ pivampicillin  prescribed in the placebo group was significantly larger ( P<.05 ) . The difference between the  penicillin doses given in the treatment and placebo groups was not significant ( P>.1 ) . ( Obstet Gynecol 65:371 , 1985
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 .