Perioperative Antibiotic Prophylaxis in Myomectomy Surgery

Abstract

Study Objective We aim to evaluate antibiotic use in myomectomy surgeries and its association with the incidence of surgical site infection (SSI). Design A retrospective cohort study design. Setting Two university-affiliated hospitals in Los Angeles. Patients or Participants The cohort includes 1177 women who underwent either laparoscopic or abdominal myomectomy between February 2013 – December 2017. Interventions We collected information regarding patient demographics, antibiotic use, surgical findings, and SSI outcomes. Measurements and Main Results Antibiotics were used in 907 (76.9%) cases. Laparoscopic myomectomy was performed in 620 (53%) cases and open myomectomy in 563 (48%) cases. Thirty-four cases (2.9%) had SSI within a 6-week postoperative period. Univariate analyses were used to compare the control group without antibiotics to treatment group with antibiotics. Patients with obesity (BMI≥30) (p=0.009), previous abdominal surgery (p=0.001), laparotomy (p 1 fibroid (p=0.0004) or aggregate fibroid weight >500g (p Conclusion ACOG guidelines do not recommend use of prophylactic antibiotics for myomectomies. However, our study demonstrates that the majority of surgeons elect to use antibiotics prophylactically. Additionally, our study suggests that antibiotic use decreases SSI in abdominal myomectomy, but does not decrease SSI in laparoscopic myomectomy. These findings contribute to the limited data informing guidelines regarding antibiotic use in myomectomy surgery.