Home Articles & Issues Published Ahead-of-Print CME Collections ABOG MOC II Podcasts Videos Journal Info
Skip Navigation LinksHome > December 2013 - Volume 122 - Issue 6 > Use of Guideline-Based Antibiotic Prophylaxis in Women Under...
Obstetrics & Gynecology:
doi: 10.1097/AOG.0b013e3182a8a36a
Contents: Original Research

Use of Guideline-Based Antibiotic Prophylaxis in Women Undergoing Gynecologic Surgery

Wright, Jason D. MD; Hassan, Khalid MD; Ananth, Cande V. PhD, MPH; Herzog, Thomas J. MD; Lewin, Sharyn N. MD; Burke, William M. MD; Lu, Yu-Shiang MS; Neugut, Alfred I. MD, PhD; Hershman, Dawn L. MD

Journal Club
Cochrane Reviews
Clinical ObGyn
Collapse Box

Abstract

OBJECTIVE: To examine guideline-based use of prophylactic antibiotics in patients who underwent gynecologic surgery.

METHODS: We identified women who underwent gynecologic surgery between 2003 and 2010. Procedures were stratified as antibiotic-appropriate (abdominal, vaginal, or laparoscopically assisted vaginal hysterectomy) or antibiotic-inappropriate (oophorectomy, cystectomy, tubal ligation, dilation and curettage, myomectomy, and tubal ligation). Antibiotic use was examined using hierarchical regression models.

RESULTS: Among 545,332 women who underwent procedures for which antibiotics were recommended, 87.1% received appropriate antibiotic prophylaxis, 2.3% received nonguideline-recommended antibiotics, and 10.6% received no prophylaxis. Use of antibiotics increased from 88.0% in 2003 to 90.7% in 2010 (P<.001). Among 491,071, who underwent operations for which antibiotics were not recommended, antibiotics were administered to 197,226 (40.2%) women. Use of nonguideline-based antibiotics also increased over time from 33.4% in 2003 to 43.7% in 2010 (P<.001). Year of diagnosis, surgeon and hospital procedural volume, and area of residence were the strongest predictors of guideline-based and nonguideline-based antibiotic use.

CONCLUSION: Although use of antibiotics is high for women who should receive antibiotics, antibiotics are increasingly being administered to women for whom the drugs are of unproven benefit.

LEVEL OF EVIDENCE: III

© 2013 by The American College of Obstetricians and Gynecologists.

Login

Article Tools

Share