RHL Commentary by Katherine Ba-Thike
EVIDENCE SUMMARY
The review analysed data from randomized controlled trials on antibiotic prophylaxis for insertion of intrauterine contraceptive devices (IUD), which included doxycycline in different dosage regimens or azithromycin versus placebo or no treatment. The outcome measures were pelvic inflammatory disease, unscheduled visits to the clinic and removal of the intrauterine contraceptive device (IUD) within three months of insertion. A reduction in unscheduled return visits due to an IUD-related problem was seen in one of the trials but the results were not replicated in other trials. Little benefit was conferred by the use of prophylactic antibiotics with respect to pelvic inflammatory disease (PID) or IUD continuation rates. All trials included in the review reported a low risk of IUD-associated infection, and IUD use was safe with or without the use of antibiotics, especially in populations with low prevalence of sexually transmitted infections (STI).
All adequately controlled trials, which could be identified, have been included and appropriately analysed. The reviewers noted the heterogeneity of study populations. High or low prevalence of sexually transmitted diseases could have been considered as a stratification variable in this review.
The full RHL commentary also includes sections on: Relevance
- Magnitude of the problem
- Feasibility of the intervention
- Applicability of the results of the Cochrane Review
- Implementation of the intervention
- Research
References
This document should be cited as: Katherine Ba-Thike. Antibiotic prophylaxis for intrauterine contraceptive device insertion: RHL commentary (last revised: 14 July 2002). The WHO Reproductive Health Library, No 9, Update Software Ltd, Oxford, 2006. www.rhlibrary.com
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