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Semenov D.M., Semenov V.M., Zanko A.S.
Optimization of the use of beta-lactam antibacterial drugs in obstetrics and gynecology

Abstract.
Objectives. To improve the efficiency of etiotropic therapy of bacterial infections and prevention of intrauterine infection of the fetus during pregnancy by optimizing the use of beta-lactam antibiotics in obstetrical and gynecologic practice based on the research of beta-lactamase activity level of the blood serum.
Material and methods. The study of blood samples (n=423), amniotic fluid (n=20) of pregnant women and gynecological female patients (n=46) with the determination of intrinsic beta-lactamase activity of the blood serum has been conducted.
Results. In all patients one or another non-zero level of intrinsic beta-lactamase activity of the blood serum has been revealed, it did not change significantly during pregnancy. The average level of beta-lactamase activity in these groups made up 54,15% of the decay of the standard quantity introduced into the sample. The group of patients (19,8%) with high (more than 68,2%) beta-lactamase activity of the blood serum has been established. In the amniotic fluid the average beta-lactamase activity level was lower compared with that of the blood serum – 33,5% (23,37; 43,79). In the group of patients with the changed scheme of antibacterial therapy high beta-lactamase activity of the blood serum was statistically significantly associated with high efficiency of beta-lactam antibiotics replacement by drugs belonging to different pharmacological classes (p<0,05) and beta-lactam antibiotics replacement led to a significant reduction in the duration of hospital stay.
Conclusions. High beta-lactamase activity of the blood serum can significantly affect the efficiency of antibacterial therapy with the group of beta-lactam drugs. The level of beta-lactamase activity of the blood serum greater than 68,2% of the total substrate-сhromogen decay requires discontinuation of therapy with beta-lactam first-line drugs in female patients and the administration of reserve antibiotics.
Key words: beta-lactam antibiotics, pregnancy, biological resistance, BIOLACTAM.

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