Antibiotic prophylaxis for intrauterine contraceptive device insertion
RHL practical aspects by Ba-Thike K
FIRST CONTACT (PRIMARY CARE) LEVEL
Service providers should be made aware of the fact that prophylactic systemic administration of antibiotics is not necessary unless there is a high prevalence of sexually transmitted infections in the local population.
Providers should be informed that they can minimize risks by observing the following guidelines:
- screening clients carefully t determine their probability of being currently infected with STDs,
- counselling clients about STD risks and any future symptoms if lower and upper genital tract infection,
- practising aseptic techniques when inserting IUDs and insert IUDs skilfully, and
- encouraging clients to return for a follow-up visit approximately one month after insertion to determine if infection is present.
If IUD use in a community is low due to perception of community members, particularly women, that IUD insertion is associated with pelvic infection, information and education should be given during client-provider interaction and during outreach activities that this is not the case for women at low risk of contracting STDs.
REFERRAL HOSPITAL (SECONDARY CARE) LEVEL
The service providers should be aware that contemporary copper IUDs are safe and effective with or without the use of prophylactic antibiotics and include this information during counselling clients. They should also reinforce this fact during the training and supervision of staff providing RH/FP services at the primary level.
AT HOME OR IN THE COMMUNITY
As misconceptions associated with IUD use deter women from using this method, accurate and consistent information should be given to women regarding the effectiveness and use of IUDs as an option for long-term, reversible contraception.
This is especially with respect to infection associated with IUD insertion which is minimal in populations at low risk for STDs.
This document should be cited as: Ba-Thike K. Antibiotic prophylaxis for intrauterine contraceptive device insertion: RHL practical aspects (last revised: 14 July 2002). The WHO Reproductive Health Library; Geneva: World Health Organization.