View all recommendations from this society

November 15, 2017; Updated October 11, 2019

Do not routinely administer prophylactic antibiotics in low-risk laparoscopic procedures.

The use of prophylactic antibiotics in women undergoing gynecologic surgery is often inconsistent with published guidelines. Although the appropriate use of antibiotic prophylaxis for hysterectomy is indicated, prophylactic antibiotics are increasingly being administered to women who are less likely to receive benefit, such as diagnostic and operative laparoscopic procedures other than hysterectomy, including cystoscopy, hysteroscopy, intrauterine device insertion, endometrial biopsy, oocyte retrieval, D&C for non-pregnancy indication, and cervical tissue biopsy, including LEEP or endocervical curettage. The potential results are significant resource use and facilitation of antimicrobial resistance.

These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physicians.

How The List Was Created

As an international leader in the advancement of minimally invasive surgery, AAGL relies on its society members and board to determine the various needs and best practices to promote safe, higher quality care to patients. The list of things to question provided to the Choosing Widely campaign was submitted to the AAGL Board, who developed a subcommittee dedicated to analyzing the recommended interventions. The subcommittee of expert surgeons in the field of minimally invasive surgery recommended and developed a more effective use of health care resources, along with safe techniques to practice. The submitted list was reviewed and approved by the AAGL Board.


Wright J et al. Use of Guideline Based Antibiotic Prophylaxis in Women Undergoing Gynecologic Surgery, Obstet Gynecol 2013; 122:1145-1153.

ACOG Practice Bulletin: Antibiotic Prophylaxis for Gynecologic Procedures, Number 104 May 2009 (Reaffirmed 2016)