Antibiotic Prophylaxis for Dilation and Curettage

Rationale for Not Using Prophylactic Antibiotics in D&C

• D&C is considered a clean or clean-contaminated procedure with a low risk of infection (<1%), which does not justify systematic antibiotic prophylaxis 1
• The French Society of Anesthesia and Intensive Care Medicine guidelines specifically state that for intrauterine procedures such as endometrial biopsy and curettage, antibiotic prophylaxis is not recommended 1, 2

Special Circumstances Where Prophylaxis May Be Considered

• High-risk patients with multiple comorbidities that increase infection risk 3

General Principles of Antibiotic Prophylaxis When Required

• Antibiotics should be administered within 60 minutes before the skin incision 3
• A single dose is typically sufficient for short procedures like D&C 3
• The antibiotic selected should cover the most likely pathogens (typically vaginal flora) 2

Common Pitfalls to Avoid

• Continuing antibiotics beyond the perioperative period for prophylaxis provides no additional benefit and increases risk of adverse effects 3
• Failing to distinguish between prophylaxis (prevention) and treatment (active infection already present) 3