A PROSPECTIVE RANDOMIZED STUDY OF THE EFFECTS OF PROPHYLACTIC ANTIBIOTICS ON THE INCIDENCE OF BACTEREMIA FOLLOWING HYSTEROSCOPIC SURGERY

Objective: To study the effect of prophylactic antibiotics on the inci dence of bacteraemia following hysteroscopic surgery. Design: Prospect ive randomised study. Setting: Aberdeen Royal Infirmary. Subjects: One hundred and sixteen women about to undergo either endometrial laser a blation (ELA) or transcervical resection of the endometrium (TCRE). In tervention : Fifty-five women were randomised to receive 1.2 g of Augm entin (co-amoxiclav) i.v. at induction of anaesthesia. Sixty-one women received no antibiotic prophylaxis. Blood cultures were obtained at t he 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 fro m 5% to 25%). The majority of organisms were of dubious clinical signi ficance and contamination could not be excluded in 7 cases out of 10. Conclusion: There is no convincing evidence that antibiotics are of va lue in this clinical setting.