Prophylactic antibiotics for transcervical intrauterine procedures
Abstract
Background
The transcervical intrauterine route is commonly used for operative gynecological procedures in women. The vagina is an area of the body that is abundant with normal bacterial flora. An operative procedure through the vagina may, therefore, be considered to have added potential for resulting in post‐procedure infection. Prophylactic antibiotics may play a role in the prevention of post‐procedure transcervical intrauterine infections.
Objectives
To assess the effectiveness and safety of antibiotic prophylaxis compared to placebo or no treatment in women undergoing transcervical intrauterine procedures.
Search methods
The search strategy was based on the Menstrual Disorders and Subfertility Group's search strategy. The following databases were searched:
Menstrual Disorders and Subfertility Group Specialized Register;
Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library 2006, Issue 4;
MEDLINE (1966 to November 2006);
EMBASE (1966 to November 2006);
Biological Abstracts (1966 to October 2006);
AMED (1966 to November 2006).
Key words were prepared, in consultation with the Trials Search Coordinator, according to the terms related to our objective: antibiotic, antibiotics, prophylaxis, transvaginal, transcervical intrauterine, endometrial sample, endometrium sampling, endometrial biopsy, hysterosalpingography, hysteroscope, hysteroscopy, hysteroscopic surgery, endometrial ablation, and endometrial resection.
Selection criteria
The review authors planned to include only truly randomized controlled trials that compared antibiotic prophylaxis with placebo or no treatment in order to prevent infectious complications after transcervical intrauterine procedures. Controlled clinical trials without randomization and pseudo‐randomized trial were excluded.
Data collection and analysis
No data collection or analysis was done because no trials were eligible for inclusion in the review.
Main results
The search did not identify any randomized controlled trials investigating the effect of antibiotic prophylaxis compared to placebo or no treatment in women undergoing transcervical intrauterine procedures.
Authors' conclusions
At this time, there are no published randomized controlled trials that assess prophylactic antibiotics effects on infectious complications following transcervical intrauterine procedures. It is, therefore, not possible to draw any conclusions regarding the use of prophylactic antibiotics for the prevention of post‐procedure transcervical intrauterine infections.
PICOs
Plain language summary
Prophylactic antibiotics for transcervical intrauterine procedures
Giving antibiotics before or following transcervical intrauterine procedures to prevent infection. The lower genital tract is an area which is abundant with normal flora (resident bacteria) so that operative procedures which pass through it may be at increased risk for infection. The operative procedure may cause contamination of the uterine cavity with vaginal or cervical flora, or both. In addition, the associated trauma may compromise the ability of the uterus to combat infection. The prophylactic administration of antibiotics (giving antibiotics before the development of any infection) in women undergoing transcervical intrauterine procedures may prevent infection post procedure. There have been no randomized controlled trials evaluating the usefulness of antibiotics for the prevention of infection after these procedure
