Use of guideline-based antibiotic prophylaxis in women undergoing gynecologic surgery

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

Research output: Contribution to journalArticlepeer-review

30 Scopus citations


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.

Original languageEnglish
Pages (from-to)1145-1153
Number of pages9
JournalObstetrics and Gynecology
Issue number6
StatePublished - Dec 2013
Externally publishedYes


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