Win May, A Metin Gülmezoglu, Katherine Ba-Thike

Unsafe abortions result not only in costs for acute care but may also be responsible for longer-term complications such as pelvic inflammatory disease, damage to reproductive organs, and secondary infertility. If effective, antibiotic prophylaxis at the time of the procedure can potentially prevent these adverse consequences. The value of routine antibiotics before surgical evacuation of the uterus in women with incomplete abortion is controversial. In some health centres antibiotic prophylaxis is advised; in others antibiotics are only prescribed when there are signs of infection. The objective of this review is to evaluate the effectiveness of routine antibiotic prophylaxis to women with incomplete abortion. We searched the Cochrane Controlled Trials Register, Pubmed/MEDLINE, EMBASE and Popline. Date of last search: January 2007. Randomised trials comparing a policy of routine antibiotic prophylaxis with no routine prophylaxis were eligible for inclusion. Data extraction was conducted by two reviewers independently. Trial quality was assessed. One study involving 140 women was included. A second well-conducted trial was excluded because of high losses to follow-up. No differences were detected in postabortal infection rates with routine prophylaxis or control. However, compliance with antibiotic treatment was also low. There is not enough evidence to evaluate a policy of routine antibiotic prophylaxis to women with incomplete abortion.