A prospective randomised study of the effects of prophylactic antibiotics on the incidence of bacteraemia following hysteroscopic surgery.

Abstract Objective : To study the effect of prophylactic antibiotics on the incidence of bacteraemia following hysteroscopic surgery. Design : Prospective randomised study. Setting : Aberdeen Royal Infirmary. Subjects : One hundred and sixteen women about to undergo either endometrial laser ablation (ELA) or transcervical resection of the endometrium (TCRE). Intervention : Fifty-five women were randomised to receive 1.2 g of Augmentin (co-amoxiclav) i.v. at induction of anaesthesia. Sixty-one women received no antibiotic prophylaxis. Blood cultures were obtained at the end of the surgical procedure. Results : Incidence of bacteraemia in the non-antibiotic group (16%) was significantly higher than that in the antibiotic group (2%) (95% confidence interval for difference from 5% to 25%). The majority of organisms were of dubious clinical significance and contamination could not be excluded in 7 cases out of 10. Conclusion : There is no convincing evidence that antibiotics are of value in this clinical setting.