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The review assessed the effectiveness of routine antibiotics prophylaxis to Dilatation and curettage, electric vacuum aspiration and manual vacuumAntibiotics should be administered on the day of the procedure and, if clinicians prefer, for no more than 3 days afterwards. Azithromycin is a macrolide that If unavailable or patient has allergy the alternative medication would be azithromycin or metronidazole. See: Low N et al. Perioperative antibiotics to prevent What is manual vacuum aspiration (MVA)?. MVA is a procedure to remove pregnancy tissue from the womb using a hand-held suction device. Treatment of Miscarriage with Manual Vacuum Aspiration (MVA). Prior to procedure in clinic: o ______Doxycycline- is an antibiotic. Step Two: Prepare the Patient. • Administer pain medication to have maximum effect when procedure begins. • Give prophylactic antibiotics to all women, and.