Can Taxim (Cefixime) Genta Metrogyl (Metronidazole and Gentamicin) be given to a patient undergoing tubal ligation?

Antibiotic Prophylaxis for Tubal Ligation

Antibiotic prophylaxis is NOT recommended for tubal ligation procedures, as this is a clean gynecologic surgery without evidence supporting routine prophylactic antibiotic use. 1, 2

Guideline-Based Recommendation

• No antibiotic prophylaxis (ABP) is indicated for tubal ligation according to European surgical prophylaxis guidelines, which explicitly list tubal ligation among procedures that do not require prophylactic antibiotics 1

• The combination you mentioned (Taxim/Cefixime + Gentamicin + Metronidazole) is not appropriate for this procedure, as it represents unnecessary antibiotic exposure without proven benefit 1, 2

Evidence Supporting No Prophylaxis

• A large observational study of 491,071 women undergoing gynecologic procedures found that 40.2% received antibiotics for operations where they were not recommended (including tubal ligation), representing guideline-discordant practice that increased over time without evidence of benefit 2

• Antibiotic prophylaxis guidelines specifically reserve antibiotics for gynecologic procedures involving:

  • Hysterectomy (abdominal or vaginal) 1
  • Cesarean section 1
  • Procedures with prosthetic material placement 1
  • NOT for tubal ligation, diagnostic laparoscopy, hysteroscopy, or IUD placement 1

When Antibiotics ARE Indicated in Gynecology

For comparison, procedures that do require prophylaxis include:

• Hysterectomy: Cefazolin 2g IV single dose (or cefamandole/cefuroxime 1.5g IV) 1
• Cesarean section: Cefazolin 2g IV single dose 1
• Laparoscopic surgery with vaginal incision: Cefazolin 2g IV or cefamandole/cefuroxime 1.5g IV 1

Critical Clinical Pitfall

Avoid the common error of administering antibiotics "just to be safe" in clean procedures like tubal ligation, as this practice:

• Increases antimicrobial resistance without reducing infection rates 2
• Exposes patients to unnecessary adverse drug reactions 3, 4
• Represents non-evidence-based medicine that has unfortunately increased over time despite clear guidelines 2

Exception: If Infection Risk Factors Present

If the patient has specific high-risk features (immunosuppression, active infection elsewhere, or conversion to laparotomy with complications), then treatment antibiotics—not prophylaxis—would be indicated based on clinical judgment, but this would represent therapeutic rather than prophylactic use 1