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Some reported a decrease in infection associated with the use of antibiotic prophylaxis, whereas others found no significant reduction in GTI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To synthesise systematically the evidence on the effect of prophylactic antibiotics compared with placebo in women undergoing surgical procedures for incomplete abortion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Search strategy<\/jats:title><jats:p>In February\u00a02020, PubMed, Embase and Cochrane Central for Register of Controlled Trials were\u00a0searched for relevant published randomised controlled trials.<\/jats:p><\/jats:sec><jats:sec><jats:title>Selection criteria<\/jats:title><jats:p>Randomised controlled trials reporting GTI following surgical procedures for incomplete abortion and comparing antibiotic prophylaxis with placebo.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data collection and analysis<\/jats:title><jats:p>Meta\u2010analysis using inverse variance heterogeneity model included subgroup and sensitivity analyses determined <jats:italic>a priori<\/jats:italic> were conducted. The quality of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE).<\/jats:p><\/jats:sec><jats:sec><jats:title>Main results<\/jats:title><jats:p>A total of 16\u00a0178 women who participated in 24 eligible randomised controlled trials published between 1975 and 2019 were included. Pooled estimates showed the risk of GTI following surgical procedures after incomplete abortion was significantly lower among those who had prophylactic antibiotics (relative risk [RR]\u00a0=\u00a00.72; 95% CI 0.58\u20130.90; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a049%). There was no significant effect of antibiotics in women in low\u2010 and middle\u2010income countries (three studies, 3579 participants, RR\u00a0=\u00a00.90; 95% CI 0.50\u20131.62; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a063%), but it was clinically and statistically significant among women high\u2010income countries (21 studies, 12\u00a0599 participants, RR\u00a0=\u00a00.67; 95% CI 0.53\u20130.84; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a044%), with a strong level of evidence as assessed by GRADE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study provides evidence that antibiotic prophylaxis is beneficial in reducing post\u2010abortion GTI among women undergoing surgical procedures for incomplete abortion. More studies are needed from low\u2010 and middle\u2010income countries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Prophylactic antibiotics after incomplete abortion are effective in reducing GTI. More studies are needed from low\u2010 and middle\u2010income countries.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.16637","type":"journal-article","created":{"date-parts":[[2020,12,22]],"date-time":"2020-12-22T01:22:30Z","timestamp":1608600150000},"page":"1273-1281","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Prophylactic antibiotics for preventing genital tract infection in women undergoing surgical procedures for incomplete abortion: a systematic review and meta\u2010analysis of randomised controlled trials"],"prefix":"10.1111","volume":"128","author":[{"given":"N","family":"Islam","sequence":"first","affiliation":[{"name":"Department of Public Health College of Health Sciences QU Health Qatar University Doha Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L","family":"Furuya\u2010Kanamori","sequence":"additional","affiliation":[{"name":"Research School of Population Health ANU College of Health and Medicine Australian National University Canberra ACT Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Mahmood","sequence":"additional","affiliation":[{"name":"Endocrinology Department, Medicine Hamad Medical Corporation Doha Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1211-6495","authenticated-orcid":false,"given":"L","family":"Thalib","sequence":"additional","affiliation":[{"name":"Department of Public Health College of Health Sciences QU Health Qatar University Doha Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,1,12]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198807283190401"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1728-4465.2010.00250.x"},{"key":"e_1_2_7_4_1","first-page":"CD001993","article-title":"Surgical procedures for evacuating incomplete miscarriage","volume":"9","author":"Tun\u00e7alp \u00d6","year":"2010","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_5_1","first-page":"607","article-title":"Evaluation of prophylactic use of tetracycline after evacuation in abortion in Harare Central Hospital","volume":"66","author":"Seeras R","year":"1989","journal-title":"East African Med J"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0166287"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(85)90594-X"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1155\/S1064744995000044"},{"key":"e_1_2_7_9_1","first-page":"1372","article-title":"Effectiveness of cefoxitin on preventing endometritis after uterine curettage for spontaneous incomplete abortion: a randomized controlled trial study","volume":"95","author":"Titapant V","year":"2012","journal-title":"J Med Assoc Thai"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1808817"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/0029-7844(95)00035-P"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007435-198504000-00004"},{"key":"e_1_2_7_13_1","volume-title":"SIGN Guideline 104. 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