Puerperal infections.
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The therapeutic possibilities of the chemotherapeutic preparation Nolicine were studied. Clinical and laboratory parameters were followed in dynamics as well as microbiological examination of lochial and wounded secretion in dynamics. The results from the study showed that the applied preparation, when its usage is contemplated with the isolated bacterial flora, is suitable for treatment of some postpartal infections especially in women, who are allergic to antibiotics.
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The authors estimated the biocenosis of vagina in women before delivery. The examination were made upon 50 women between 28 and 40 week of pregnancy and on the third day after delivery; comparing the results of estimation the purity of vagina and bacterial inoculations in two groups of pregnant women:-control group (without G-P 150 treatment) and in group with G-P 150 application. The authors proved the entire disappearance of mycotic infection (candida albicans) in women treated with G-P 150. The also stated that potential pathogenic bacterial flora during puerperium occurs much more rarely.
The effect of some semi-synthetic penicillins, such as methicillin and oxacillin and cephalosporings, such as cephaloridin on the condition of the blood coagulation system in 85 patients with postnatal mastitis and endomyometritis was studied. It was shown that the above antibiotics had no significant effect on the parameters of the blood coagulating system. A decrease in the fibrinogen level was found in the mastitis patients treated with semi-synthetic penicillins and cephaloridin. An increase in the prothrombins index in the patients treated with methicillin oxacillin was shown. The use of the semi-synthetic penicillins and cephaloridin for the therapy of the puerpera with endomyometritis resulted in prolongation of the recalcification period. A decrease in the fibrinolytic activity most pronounced in therapy with cephaloridin was also found. Therefore, the above changes in the blood coagulating system of the puerpera with postnatal infections subjected to short-term treatment courses were insignificant and required no special correction.
From the third to the sixth day postpartum transcervical endometrial swabs were taken from 51 women with the clinical signs of endometritis, like fever over 38 degree C, uterine tenderness and purulent lochia using prereduced anaerobic transport-media. The specimens were cultured aerobically and anaerobically. 27 women had an endometritis following vaginal delivery, 24 following caesarian section. Following vaginal delivery aerobic bacteria were isolated in 85.2% of the cases and anaerobic bacteria in 62.9%, post caesarian section in 75.1% aerobic and in 83.3% anaerobic bacteria. A mixed aerobic/anaerobic infection was found in 48.1% following vaginal delivery and in 58.4% post caesarian section. The aerobes most frequently recovered were Staphylococcus epidermidis, E. coli, Enterocococci and Streptococci, the prevalent anaerobes were the grampositive anaerobic cocci, Peptostreptococcus and Peptococcus, and Bacteroides species. Our results suggest that anaerobic bacterial play an important role in the endometritis post partum and that frequently a polymicrobial aerobic/anaerobic infection is present. Therapeutically, anaerobes should be taken into consideration especially for the treatment of severer infections following caesarian section. In such cases the 5-Nitroimidazoles, such as Metronidazole or antibiotics effective against anaerobes as Clindamycin or Cefoxitin should be administered.
The author undertakes a study to investigate the protracted delivery with different duration of prematurely ruptured membranes, to investigate and to compare the morbidity and structure of patients. To investigate the lochia secretions and to compare the microflora of the patients with ruptured membranes at different times with a view to their influence by antibiotic prophylaxis. At the end author makes appropriate conclusions.
Low concentrations of ampicillin were found in colostrum/breast milk from 6 mothers treated with pivampicillin 1.05 to 2.1 g daily during the first to eighth day postpartum in the maternity ward. It was calculated that the breast-fed infant could theoretically receive 0.05-0.37% of the dose/kg given to the mother. It is concluded that direct exposure of the breast-fed infant suckling from a mother under treatment with ampicillin or pivampicillin seems to be minimal.
The effect of semisynthetic penicillins, such as methicillin and oxacillin and cephalosporins, such as cephaloridin of immunity and protein metabolism was studied on 63 patients with postnatal mastitis and endomyometritis. It was shown that the above antibiotics had no significant effect on the immunological reactivity and protein metabolism. However, lower titers of alpha-antitoxin, lysine levels and C-reactive protein content were registered in the mastitis patients treated with cephaloridin. Therefore, while recomending antibacterial drugs their effect on the immunity and protein metabolism should be taken into account and from this point of view semisynthetic penicillins are preferable in treatment of mastitis patients and semisynthetic penicillins and cephaloridin are preferable in treatment of endomyometritis patients.