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Data lacking to support antibiotics at IUD insertion.


 Despite a lack of clinical evidence to support prophylactic antibiotic use at the time of IUD insertion, many clinicians continue this practice. A 1994 survey of "Contraceptive Technology Update" readers found that 75% of clinicians who provide IUDs supported prophylactic antibiotic use in case the woman had chlamydia or gonorrhea bacteria at the cervix. Two large, independent, controlled studies conducted in Kenya and Nigeria failed to detect significantly lower rates of pelvic inflammatory disease (PID) 3 months after IUD insertion in women treated with antibiotics compared to a placebo. In fact, in the Nigerian study, the rate of PID was 0.6% among the 721 women who received antibiotics and only 0.3% among the 708 women in the placebo group. The Planned Parenthood Federation of America does not endorse the routine prophylactic use of antibiotics at IUD insertion. A Los Angeles (California) Regional Family Planning Council study is underway of 1800 women administered 500 mg of azithromycin before IUD insertion; findings should help to clarify the issue.
