Is antibiotic prophylaxis necessary in elective laparoscopic surgery for benign gynecologic conditions?

The use of prophylactic antibiotics in gynecologic laparoscopic surgery is still popular and many gynecologic surgeons believe that prophylactic antibiotic therapy will decrease the incidence of postoperative infection complications.

The aim of this prospective cohort study was to investigate the opportunity of prophylactic antibiotics to prevent early postoperative infections and febrile morbidity in elective laparoscopic surgery for benign gynecological conditions.

300 women who underwent laparoscopic surgery for benign gynecological conditions were included in the study. After the patients were included they were divided in two groups (ratio 1:1). Group A (n = 150) received 2 g of cefazolin (Cefamezin; Pfizer Italia Srl, Italy) 30 min before surgery and group B (n = 150) received no antibiotic prophylaxis.

No postoperative infection was diagnosed for a total of 300 study patients. The overall rate of febrile morbidity was 3.3% for a total of 300 patients (1.3% for group A and 2% for group B). No differences in infection complications and febrile morbidity were found between the two groups.

Postoperative infection complications in laparoscopic gynecologic surgery without antimicrobial prophylaxis are negligible and overlapping to those obtained with cefazolin prophylaxis.