Prophylactic Antibiotic Treatment during Hysteroscopy: A Systematic Review

Background: Overall, the use of antibiotics is increasing. We noticed different practices amongst different hospitals in their prophylactic use of antibiotics during operative hysteroscopy. This review investigates whether there is sufficient evidence to recommend antibiotic prophylaxis in operative hysteroscopy. Methods: We performed a systematic search in “Pubmed” using “hysteroscopy” and “antibiotic” and “prophylaxis” as search items. We found 16 hits of which 4 were suitable to include in our review. Findings: In an included Cochrane review no conclusion was drawn since no articles could be included. A prospective study by Nappi et al. [1] support the recommendation of the American College of Obstetricians and Gynaecologists not to prescribe routinely antibiotic prophylaxis in cases of hysteroscopic surgery. Bhattacharya et al. conducted a prospective study that was ended prematurely. They conclude that there is no convincing evidence that prophylactic antibiotics are of value in hysteroscopy. A review by Morrill et al. yielded no new data. Conclusion: We did not find a significant increase in clinical relevant infectious symptoms after hysteroscopy in women treated with or without antibiotic prophylaxis, although data are insufficient to draw a definite conclusion. Therefore, we suggest a prospective study is mandatory on this topic.