Chapter 14: Obstetrics & Gynecological Diseases
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Routine antibiotics for women are not recommended with the following conditions:
- Uncomplicated vaginal birth (vaginal birth in the absence of any specific risk factors or any clinical signs of infection)
- Episiotomy
- Meconium-stained amniotic fluid (Antibiotics is recommended only when the characteristics of liquor suggests infection)
- There is insufficient evidence for or against the use of prophylactic antibiotics to reduce infectious morbidity for manual removal of the placenta
- Available evidence does not support the use of prophylactic antibiotics to reduce infectious morbidity following elective or emergency cervical cerclages
- The evidence is not robust for the use of antibiotic prophylaxis to prevent perineal wound complications following third- or fourth-degree tears.
Prophylactic antibiotics in gynecology
There are no recommendations for routine prophylactic antibiotics for the following gynecological procedures in healthy women with no risk factors:
- Insertion of intrauterine contraceptive device (IUCD)
- Patients undergoing diagnostic laparoscopy
- Patients having hysteroscopic surgery
- Hysterosalpingography (HSG) without a prior history of pelvic inflammatory disease
- Large Loop Excision of Transformation Zone (LLETZ)
Broad spectrum antibiotics should be used during major abdominal, laparoscopic or vaginal procedures.
