Incidence of bacteremia at dilation and curettage.

The American Heart Association does not recommend prophylactic antibiotics for patients undergoing dilation and curettage (D & C) except in the case of septic abortion or the presence of prosthetic valves. This recommendation is based on a retrospective analysis of case reports of infectious complications of D & C. To date we are unaware of prospective studies that answer this question. At a community hospital we studied 20 patients undergoing D & C for noninfectious indications. Aerobic and anaerobic blood cultures were performed before and during the D & C. All baseline cultures were negative. In one patient we were able to isolate Lactobacillus after the D & C, thus finding a 5% incidence of bacteremia. That places D & C in the same risk category as other diagnostic procedures considered low risk in the pathogenesis of subacute bacterial endocarditis. Our study thus validated the recommendations made by the American Heart Association.