A literature review of the current evidence for routine antibiotic prophylaxis after cervical tissue excisions

Abstract

Consistent data are available on supporting the routine use of prophylactic antibiotics for several obstetrical and gynaecological procedures. According to the Surgical Wounds Classification scheme, operations involving the vagina are included in the clean-contaminated category of procedures, and guidelines recommend the routine use of prophylactic antibiotics. The objective of this paper is to review the current evidence regarding prophylactic antibiotics for cervical tissue excisions. We performed a systematic search of medical databases to March 2014 and we found three randomised controlled trials reporting on the role of prophylactic antibiotics in 683 patients who underwent cervical excisions. When compared with controls, the prophylactic antibiotics group was similar in terms of postoperative bleeding, vaginal discharge, pain, incidence of adverse events, requirement of antibiotics and readmission rate secondary to bleeding. This systematic review based on three randomised controlled trials suggests that current evidence does not support the routine prophylactic antibiotics for cervical tissue excisions.

Keywords::

• Antibiotic prophylaxis
• conisation
• LEEP
• LLETZ
• loop excision

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.