Purpose. To study the pharmacokinetics of -lactam antibiotics in the development of endometritis after cesarean section to select the optimal dosage regimen. Methods. A prospective, randomized, single-center study included 52 women in puerperas with endometritis after a caesarean section, divided into four groups. The patients of the first group (n = 17) received a course of ceftriaxone bolus in a single dose of 2.0 g (n = 10) and in the mode of prolonged perioperative infusion (n = 7). The patients of the second group (n = 10) received cefepim bolus at a dose of 2.0 g 2 times a day (n = 5) and in the extended infusion mode (n = 5). The patients of the third group (n = 14) received amoxicillin / clavulanic acid (Amoxiclav 1000 mg + 200 mg) bolus at a dose of 1.0 g 3 times a day (n = 7) and in the extended infusion regimen (n = 7). The patients of the fourth group (n = 11) received ampicillin / sulbactam (Ampisid 1000 mg + 500 mg) bolus at a dose of 1.0 g 4 times a day (n = 6) and in the extended infusion regimen (n = 5). We have compared the concentration of the studied antibiotics in the uterine cavity in the four groups using high performance liquid chromatography. Results. The effective bactericidal concentration (C 4MIC) was not maintained throughout the entire dose interval in any of the treatment groups. The clinical efficacy and safety of the studied antibiotic regimens were similar. However, prolonged infusion of cefepime and aminopenicillins provided significantly higher concentrations in lochia. Conclusion. Prolonged intravenous infusion of cefepime, ceftriaxone, amoxicillin / clavulanic acid and ampicillin / sulbactam in the treatment of endometritis after a caesarean section improves the pharmacokinetic / pharmacodynamic characteristics of these -lactams in the uterine cavity, compared with the traditional bolus administration.

Introduction: the following research investigates an availability of a long-lime treatment of postpartum infection by using of Cephalozolin (the Cephalosporine of generation I). Matherials and Methods. Lochia samples were obtained from the uterine cavities of 21 puerperal women who did not receive drug after delivery and were cultured for the identification and the determination of the susceptibilities of the clinical isolates to Cephalozolin. The concentrations of Cephalozolin in the supernatants were measured by highperformance liquid chromatography. Results. We determined the sensivity of the most clinically important bacteria to Cephazoline and its penetration rate to the uterine cavity. We found out the following bacteria which are sensible to Cephazoline – S. agalactiae, E. coli, K. pneumoniae, E. aerogenes. A low rate of Cephazoline ≤ 0,78 mg/ml was inhibited the growth of mentioned above bacteria. Cephazoline is also active as for S. aureus – MIC90 and was equal 3.13 mg/ml. In 3 hours after the injection of 1.0 gr of Cephazoline there was a maximum concentration in a venous blood – 1.63 mg/ml. The concentration of Cephazoline in lochia was rising gradually and it maximum in the uterus cavity in 5 hours was 1.26 mg/ml, and then its slowly went down. Conclusions. The mention above results let us suggest that Cephazoline is penetrates actively to lochia and its still has a good antibacterial effect. Cephazoline is still a treatment of choice as for prevention and a treatment of postpartum surgical site infections by a sensitive microorganism.