Department of Obstetrics and Gynecology, Kaiser Medical Center San Francisco, San Francisco, USA.
Int J Gynaecol Obstet. 2013 Jan;120(1):10-5. doi: 10.1016/j.ijgo.2012.06.023. Epub 2012 Oct 4.
Antibiotic prophylaxis for surgery is commonly used and is recommended by multiple organizations.
To critically review gynecology-specific data regarding surgical antibiotic prophylaxis in selected benign gynecologic surgeries.
MEDLINE and Cochrane databases were searched from inception to July 2010.
Randomized controlled trials of benign vaginal, cervical, transcervical, abdominal, or laparoscopic procedures other than hysterectomy comparing prophylactic antibiotic use with placebo or with another antibiotic. Outcomes of interest were postoperative infections, additional treatments, and adverse events.
In total, 19 trials met the inclusion criteria. Studies were individually assessed for methodologic quality, then grouped by procedure and evaluated for evidence quality.
There was no difference in infectious outcome for loop electrosurgical excision, hysteroscopic ablation, or laparoscopy, although evidence quality was poor. Fair evidence supports antibiotic prophylaxis for suction curettage or laparotomy. There were insufficient data regarding vaginal surgery prophylaxis.
Antibiotic prophylaxis may be beneficial in first-trimester suction curettage and laparotomy. No advantage was found for loop electrosurgical excision, hysteroscopy, or laparoscopic gynecologic surgery. Newer procedures and vaginal surgery lack research and merit study.
手术中预防性使用抗生素是一种常见的做法，并且被多个组织推荐。
批判性地回顾特定于妇科的手术中预防性使用抗生素的相关数据，这些手术包括一些良性妇科手术。
从建库开始到 2010 年 7 月，我们检索了 MEDLINE 和 Cochrane 数据库。
比较预防性使用抗生素与安慰剂或其他抗生素在良性阴道、宫颈、经宫颈、腹部或腹腔镜手术（除子宫切除术以外）中的随机对照试验。我们关注的结局包括术后感染、额外治疗和不良事件。
共有 19 项试验符合纳入标准。单独评估了这些研究的方法学质量，然后根据手术类型进行分组，并评估证据质量。
电环切除术、宫腔镜消融术或腹腔镜手术的感染结局无差异，尽管证据质量较差。有一定证据支持预防性使用抗生素治疗吸引刮宫术或剖腹术。阴道手术预防用抗生素的数据不足。
抗生素预防可能对早孕吸刮术和剖腹术有益。电环切除术、宫腔镜或腹腔镜妇科手术没有优势。新的手术和阴道手术缺乏研究，值得进一步研究。
