Chapter 3. Recommendations and best practice statements across the continuum of abortion care

Clinical services Recommendation 9: Antibiotic prophylaxis for surgical and medical abortion (3.3.4)

3.3.4 Antibiotic prophylaxis

The role of antibiotics is pertinent for surgical abortion. The presence of infection in the lower reproductive tract at the time of surgical abortion is a risk factor for post-abortion reproductive tract infections (129). Provision of antibiotics at the time of abortion (prophylaxis) is to prevent such complications after a surgical abortion.

CLINICAL SERVICES Recommendation 9: Antibiotic prophylaxis for surgical and medical abortion

a. For surgical abortion, regardless of the individual’s risk of pelvic inflammatory infection: Recommend appropriate prophylactic antibiotics pre- or perioperatively.

b. For medical abortion: Recommend against the use of prophylactic antibiotics.


  • Lack of antibiotics should not limit access to abortion services.

Source: Recommendation 11 carried forward from WHO (2012) (19). The wording has been revised to use the word “recommend” to clarify that these are strong recommendations, and the former wording “routine use” (in 9b) has been changed to “use”, following discussion among the expert panel.

Implementation consideration

For information regarding which health workers can provide this intervention, refer to Recommendation 24 on vacuum aspiration (< 14 weeks) and Recommendation 26 on dilatation and evacuation (D&E) (≥ 14 weeks).

Implementation consideration

Single-dose administration of nitroimidazoles, tetracyclines or penicillins has been shown to be effective when used as prophylactic antibiotics for surgical abortion.


  • States must ensure adequate access to essential medicines in an affordable and non-discriminatory manner.

For further information and sources, please refer to Box 1.2 and Web annex A: Key international human rights standards on abortion.