title: Antibiotic prophylaxis for selected gynecologic surgeries.
abstract: BACKGROUND
  Antibiotic prophylaxis for surgery is commonly used and is recommended by multiple organizations.
  
  
  OBJECTIVE
  To critically review gynecology-specific data regarding surgical antibiotic prophylaxis in selected benign gynecologic surgeries.
  
  
  METHODS
  MEDLINE and Cochrane databases were searched from inception to July 2010.
  
  
  METHODS
  Randomized controlled trials of benign vaginal, cervical, transcervical, abdominal, or laparoscopic procedures other than hysterectomy comparing prophylactic antibiotic use with placebo or with another antibiotic. Outcomes of interest were postoperative infections, additional treatments, and adverse events.
  
  
  METHODS
  In total, 19 trials met the inclusion criteria. Studies were individually assessed for methodologic quality, then grouped by procedure and evaluated for evidence quality.
  
  
  RESULTS
  There was no difference in infectious outcome for loop electrosurgical excision, hysteroscopic ablation, or laparoscopy, although evidence quality was poor. Fair evidence supports antibiotic prophylaxis for suction curettage or laparotomy. There were insufficient data regarding vaginal surgery prophylaxis.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Obstetrics and Gynecology, Kaiser Medical Center San Francisco, San Francisco, USA.
authors.forename: Michelle Y
authors.initials: MY
authors.lastname: Morrill
authors.forename: Megan O
authors.initials: MO
authors.lastname: Schimpf
authors.forename: Husam
authors.initials: H
authors.lastname: Abed
authors.forename: Cassandra
authors.initials: C
authors.lastname: Carberry
authors.forename: Rebecca U
authors.initials: RU
authors.lastname: Margulies
authors.forename: Amanda B
authors.initials: AB
authors.lastname: White
authors.forename: Lior
authors.initials: L
authors.lastname: Lowenstein
authors.forename: Renée M
authors.initials: RM
authors.lastname: Ward
authors.forename: Ethan M
authors.initials: EM
authors.lastname: Balk
authors.forename: Katrin
authors.initials: K
authors.lastname: Uhlig
authors.forename: Vivian W
authors.initials: VW
authors.lastname: Sung
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000009:adverse effects / Q000379:methods*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D011183:Postoperative Complications / Q000517:prevention & control; D013530:Surgical Wound Infection / Q000517:prevention & control
chemical_list: D000900:Anti-Bacterial Agents