[Antibiotic prevention and treatment in cesarean section]

The aim of the authors ia to study the role of antibiotic prophylaxis in cesarean section for prevention of infectious complications during puerperium. 443 deliveries were studied, which took place by cesarean section at the obstetric clinic of the Higher Medical Institute in the town of Pleven for a 2-year period. One antibiotic was administered in 96 women (21.67%) up to the third day, but in 62 women--up to the sixth day (14.00%). Two antibiotics were used is 49 parturients (11.06%) up to the third day, but in 131 women (29.57%) up to the sixth day. The combination of 3 antibiotics, containing a preparation against anaerobic infection, was used in 43 women (9.7%). The most frequent complication--endometritis was observed in 17 of operated women (3.84%), but suppuration of the operative wound--in 8 women (1.81%). After a 6-day prophylaxis with penicillin and gentamycin the frequency of endometritis was higher than that with ampicillin and gentamycin (11.76% against 2.60%). An impression was created that there was not a single case with endometritis and only one case with suppuration among 62 (13.99%) women operated without usage of antibiotics as well as in 145 (32.73%) women with antibiotic therapy up to the third day. All these parturients were with low risk of puerperal infection. Our position is that they do not need antibiotic prophylaxis.