Perioperative antibiotic prophylaxis for abdominal delivery at the regional perinatal center

Abstract

Aim. To conduct a comparative pharmacoepidemiological study and assess the rational use of antibiotics in women undergoing caesarean section. Methods. A retrospective analysis of 1,025 birth histories of women after planned and emergency cesarean section was carried out with a detailed assessment of the use of antibiotics in 2007-2009 (523) and 2016-2017 (502) - with an interval of 10 years for which new clinical guidelines, principles of rational pharmacotherapy and evidence-based medicine were introduced. The time of administration of the first dose, duration of administration, consumption of antibiotics were assessed. The significance of differences in relative indicators was assessed according to Pearson (χ2). Results. Antibiotics were prescribed to women with planned and emergency caesarean section in 100% of cases in the first period of the study (2007-2009) and prescribed in 98% of women with planned caesarean section and 96% with emergency caesarean section in the second period (2016-2017). In the first period, the first dose of antibiotic was administered: in 110 (44%) cases during surgery and 139 (56%) cases after surgery in planned caesarean section; in 139 (51%) cases during surgery and 135 (49%) cases after surgery in emergency caesarean section. In the second period, antibiotics were administered 30-60 minutes before the operation in 263 (96%) cases in the planned caesarean section and 218 (95%) cases in the emergency; postoperative antibiotics were administered in 7 (2%) women in the planned caesarean section and 2 (1%) women in the emergency (p <0.05). Greater than 5-6 days of antibiotics were used: in 166 (67%) women in the planned operation and 166 (61%) in the emergency for the first period; in 43 (16%) women with the planned operation, and 38 (17%, p <0.05) women with an emergency for the second period. In the first period, 13 antibiotics from 8 pharmacotherapeutic groups were used and in the second period, 7 out of 5 were used. Conclusion. From 2007 to 2017, the use of antibiotics has become to comply with the implemented clinical guidelines for abdominal delivery: the duration of antibiotic use has decreased, the time of administration of the first dose and the range of antibiotics used changed.