Antibiotic prophylaxis for intrauterine contraceptive device insertion
RHL practical aspects by Faúndes A
FIRST CONTACT (PRIMARY CARE) LEVEL
The Cochrane Review reinforces that appropriate selection of women with low risk of PID is the main strategy for preventing its development among IUD users and that there is no technology available to substitute for good screening. Women suspected of being carriers of pathogens in the cervix should be referred to a higher level of care.
REFERRAL HOSPITAL (SECONDARY CARE) LEVEL
The secondary care level should be prepared to provide care without delay to any woman who has recently had an IUD inserted and presents with signs or symptoms suggestive of PID. Early treatment of all cases that may be developing an upper genital tract infection is the best available strategy for preventing the sequelae of PID.
AT HOME OR IN THE COMMUNITY
Until such time as a way is found to prevent PID following IUD insertion in women who may already be carrying a sexually transmitted disease (STD) pathogen, the concept that modern IUDs are highly effective and safe contraceptive methods but are not appropriate for women at high risk of STDs should be widely disseminated among the communities.
This document should be cited as: Faúndes A. Antibiotic prophylaxis for intrauterine contraceptive device insertion: RHL practical aspects (last revised: 1 December 2001). The WHO Reproductive Health Library; Geneva: World Health Organization.