Risk-based versus alternative algorithms for antibiotic prophylaxis among women seeking early suction abortion: a...

Area of Science:

• Reproductive Health
• Infectious Disease Prevention
• Health Economics

Background:

• Resource-poor settings require simple, cost-effective methods for antibiotic prophylaxis to prevent sequelae of Chlamydia trachomatis, Neisseria gonorrhoeae, and bacterial vaginosis in women undergoing abortion.
• Effective strategies are needed to target prophylaxis, especially in settings with limited resources.

Purpose of the Study:

• To determine the prevalence of and risk factors for infections in women seeking abortion in Bali, Indonesia.
• To develop a cost-effective, risk-based prophylaxis algorithm using this data.

Main Methods:

• A cross-sectional analysis was conducted.
• Data-based simulations were used to evaluate risk-based and alternative prophylaxis algorithms.

Main Results:

• The risk-based algorithm could have provided prophylaxis to 70% of women with cervical infections and 64% with bacterial vaginosis.
• This algorithm demonstrated superior cost-effectiveness for cervical infections and acceptable cost-effectiveness for bacterial vaginosis compared to other evaluated methods.

Conclusions:

• Risk-based algorithms show promise for cost-effectively identifying women who would benefit from preabortion prophylaxis.
• Further prospective studies are necessary to confirm these findings and validate the algorithm's efficacy.