Antibiotic prophylaxis for hysteroscopy evaluation of the uterine cavity.
OBJECTIVE
To assess the prevalence of infectious complications and the protective effect of prophylactic antibiotic treatment after diagnostic office hysteroscopy in asymptomatic, infertile patients with normal results from transvaginal sonography.


METHODS
Recording of infectious complications after routine hysteroscopy in the context of a randomized controlled trial; pseudorandomized, center-specific application of antibiotic prophylaxis.


METHODS
Two tertiary infertility care units.


METHODS
Six hundred thirty-one unselected, asymptomatic, infertile women who underwent routine, diagnostic hysteroscopy prior to a first in vitro fertilization (IVF) or intracytoplasmic sperm injection treatment.


METHODS
Depending on the hospital and according to local protocols, hysteroscopy was performed with or without antibiotic prophylaxis.


METHODS
The prevalence of infectious complications after routine hysteroscopy.


RESULTS
Of the 631 women who underwent routine, diagnostic hysteroscopy, antibiotic prophylaxis was prescribed to 266 women, whereas 365 women underwent the procedure without prophylaxis. Only one infectious complication occurred (0.4%) in a patient who had not undergone therapeutic interventions and had taken antibiotic prophylaxis. This complication was successfully treated with antibiotics on an outpatient basis.


CONCLUSIONS
Considering the extremely low risk of infectious complications and the lack of evidence, suggesting a beneficial effect of antibiotic prophylaxis, its use for routine, diagnostic office hysteroscopy should not be recommended.
Kasius
Jenneke C
JC
Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Utrecht, The Netherlands. j.c.kasius@umcutrecht
Broekmans
Frank J
FJ
Fauser
Bart C
BC
Devroey
Paul
P
Fatemi
Human M
HM
D000328:Adult; D000553:Ambulatory Care / Q000379:methods; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000008:administration & dosage; D019072:Antibiotic Prophylaxis / Q000379:methods*; D003141:Communicable Diseases / Q000188:drug therapy / Q000453:epidemiology; D004318:Doxycycline / Q000008:administration & dosage; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects / Q000379:methods*; D007247:Infertility, Female / Q000188:drug therapy* / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D015995:Prevalence; D014599:Uterus / Q000187:drug effects / Q000601:surgery*
D019980:Amoxicillin-Potassium Clavulanate Combination; D004318:Doxycycline