title: Antibiotic prophylaxis in diagnostic hysteroscopy: is it necessary or not?
abstract: OBJECTIVE
  Surgical site infection remains the most common complication of surgery. Up to 5% of patients undergoing operative procedures will develop an infection leading to a prolonged hospital stay with increased cost. On the other hand the indiscriminate use of antibiotics has been associated with the development of antibiotic-resistant bacteria. The aim of this study was to examine the effect of antibiotic prophylaxis in cases of diagnostic hysteroscopy.
  
  
  METHODS
  This was an eight-year randomized controlled clinical trial. The study group consisted of 364 women who underwent diagnostic hysteroscopy because of menometrorrhagia, post-menopausal vaginal bleeding, ultrasound findings of increased thickness of the endometrium, or as a routine examination prior to a first in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) treatment.
  
  
  RESULTS
  Of the 364 women who underwent diagnostic hysteroscopy during this eight-year study period, 176 received antibiotic prophylaxis whereas 188 did not. There were no significant differences in the prevalence of postoperative infections observed between women who received antibiotic prophylaxis (0.57%) and those who underwent the procedure without prophylaxis (0.53%).
  
  
  CONCLUSIONS
  Given the very low risk of infection after diagnostic hysteroscopy and lack of evidence of efficacy, routine antibiotic prophylaxis is not recommended.
authors.affiliation: 2ND Department of Obstetrics and Gynecology, University of Athens, Aretaieion Hospital, Greece. p_bakas@yahoo.com
authors.forename: O
authors.initials: O
authors.lastname: Gregoriou
authors.forename: P
authors.initials: P
authors.lastname: Bakas
authors.forename: C
authors.initials: C
authors.lastname: Grigoriadis
authors.forename: M
authors.initials: M
authors.lastname: Creatsa
authors.forename: C
authors.initials: C
authors.lastname: Sofoudis
authors.forename: G
authors.initials: G
authors.lastname: Creatsas
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects*; D008875:Middle Aged; D013530:Surgical Wound Infection / Q000517:prevention & control*
chemical_list: D000900:Anti-Bacterial Agents