The prevention of infectious complications of caesarean section in the context of the global rise of antibiotic resistance

Abstract

In the context of the global rise of antibiotic resistance, optimising the prevention of infectious complications of caesarean section (CS) with a reassessment of the guidelines for ultra-short antibiotic (AB) regimens is becoming increasingly important. Given the current data on the negative consequences of the use of AB in pregnant women for the fetal microbiota, the role of antiseptics that are used locally, do not pass to the child, and are less likely to cause resistance, have a wider range of antimicrobial activity is increasing.The objective: to provide clinical evidence for the prevention of infectious complications of CS by topical application of an antiseptic with decamethoxin.Materials and methods. A comparative study of two homogeneous groups of women with low infectious risk delivered by elective CS was conducted. In the 1st group (55 women) an antiseptic with decamethoxin was used at all stages of abdominal delivery: preoperative treatment of the skin and vagina, intraoperative irrigation of the inner surface of the uterus, uterine sutures, and subcutaneous tissue. The 2nd group (55 patients) received conventional antibacterial prophylaxis. In the course of clinical and microbiological parallels, ultrasound monitoring of uterine involution, the results of the examination on the 42nd day after CS and information on the condition of the newborn child were used.Results. The absence of infectious complications of puerperium, infection of the surgical site, trends and signs of inflammatory reactions in both groups was revealed.In the 2nd group 5.5% of patients had partial skin suture separation due to seroma formation and transient infiltration of the subcutaneous tissue. The absence of such phenomena in the 1st group should be considered a consequence of the cytoprotective effect of decametoxin. The use of an antiseptic with decametoxin has pharmacoeconomic advantages over antibiotic prophylaxis regimens.Conclusions. The use of antiseptic with decametoxin in the perioperative care of caesarean section combines the possibility of safe reduction of antibiotics, effective antiinfective protection with guaranteed safety for the child.