The empiric antibacterial therapy of postpartum endometritis


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Abstract

The purpose of study. To ameliorate results of treatment of postpartum endometritis if puerperals labored in Moscow as a result of prescription of effective empiric antibacterial therapy Material and methods. The sampling of 50 puerperals with endometritis as complication during postpartum period was examined. In all female patients, the inoculation of secretion of uterine cavity was taken and successive determination of sensitivity to antibacterial pharmaceuticals was applied using agar diffusion method. The results. In all inoculations in diagnostic significant titers (≥105 CFU/ml), in overwhelming majority of cases the associations of microorganisms were secured where leading positions occupied by Enterococcus faecalis and faecium, Escherichia coli and Staphylococcus aureus. Conclusion. The Amoxicillin/Clavulanic acid is pharmaceutical of choice in treatment of postpartum endometritis of average degree of severity. The combination of Levofloxacin and Metronidazole is an alternative scheme of treatment of postpartum endometritis of average degree of severity. Under severe endometritis with syndrome of systemic inflammatory reaction carbapenems are pharmaceuticals of choice.

About the authors

M. A Kurtser

The N.I. Pirogov Russian national research medical university

117997, Moscow, Russia

Tat’yana S. Kotomina

The municipal clinical hospital №52 of the Moscow Health Department

Email: tatakotomina@mail.ru
candidate of medical sciences, head of department of pathology of pregnant women The municipal clinical hospital №52 of the Moscow Health Department 123182, Moscow, Russia

A. D Podtetenev

The S.S. Yudin municipal clinical hospital of the Moscow Health Department

Moscow, Russia

References

  1. Горин В.С., Матвеева И.В., Дремова В.В., Попова Ж.Ю., Чернякина О.Ф. Роль иммунной системы в патогенезе гнойно-воспалительных заболеваний пуэрперия. Сибирский медицинский журнал (Иркутск). 2012; 108(1): 5-10.
  2. Серов В.Н. Профилактика материнской смертности. Акушерство и гинекология. 2011; 7(1): 4-10.
  3. Французов В.Н., Ананьева В.В., Ордиянц И.М., Подтетенев А.Д., Варнавин О.А. Диагностическое значение прокальцитонина у больных с послеродовыми гнойно-септическими осложнениями. Российский медицинский журнал. 2011; (5): 28-31.
  4. Momoh M.A., Ezugworie O.J., Ezeigwe H.O. Causes and management of puerperal sepsis: the health personnel view point. Adv. Biol. Res. (Rennes). 2010; 4 (3): 154-8.
  5. Johnson M.T., Reichley R., Hoppe-Bauer J., Dunne M., Micek S., Kollef M. Impact of previous antibiotic therapy on outcome of Gramnegative severe sepsis. Crit. Care Med. 2011; 39(8): 1859-65.
  6. Micek S.T., Welch E.C., Khan J., Pervez M., Doherty J.A., Reichley R.M. et al. Empiric combination antibiotic therapy is associated with improved outcome against sepsis due to gramnegative bacteria: a retrospective analysis. Antimicrob. Agents Chemother. 2010; 54(5): 1742-8.
  7. Басиладзе Е.Н., Орджоникидзе Н.В., Ванько Л.В. Клинико-иммунологические критерии пуэрперия у родильниц с высоким инфекционным риском. Проблемы репродукции. 2011; (2): 96-9.
  8. Anderson B.L. Puerperal group A streptococcal infection: beyond Semmelweis. Obstet. Gynecol. 2014; 123(4): 874-82.
  9. Rimawi B.H., Soper D.E., Eschenbach D.A. Group A streptococcal infections in obstetrics and gynecology. Clin. Obstet. Gynecol. 2012; 55(4): 864-74.
  10. Lamy C., Zuily S., Perdriolle E., Gauchotte E., Villeroy-de-Galhau S., Delaporte M.O. et al. Management of post-partum infections. J. Gynecol. Obstet. Biol. Reprod. (Paris). 2012; 41(8): 886-903.
  11. Гуртовой Б.Л., Ванько Л.В., Касабулатов Н.М. Клинико-иммунологические особенности родильниц с послеродовым эндометритом. Акушерство и гинекология. 2006; (1): 30-4.
  12. Cattoir V., Giard J.C. Antibiotic resistance in Enterococcus faecium clinical isolates. Expert Rev. Anti Infect. Ther. 2014; 12(2): 239-48.
  13. Rubinstein E., Keynan Y. Vancomycin revisited - 60 years later. Front. Public Health. 2014; 31(2): 217.
  14. Sedláková M.H., Urbánek K., Vojtová V., Suchánková H., Imwensi P., Kolář M. Antibiotic consumption and its infl uence on the resistance in Enterobacteriaceae. BMC Res. Notes. 2014; 7: 454.
  15. Edelsberg J., Weycker D., Barron R., Li X., Wu H., Oster G. et al. Prevalence of antibiotic resistance in US hospitals. Diagn. Microbiol. Infect. Dis. 2014; 78(3): 255-62.

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