In the appointment of antibacterial drugs for the treatment of the GDH in pregnant women should consider the duration of pregnancy. In the first trimester, at the stage of organogenesis, the fetus is most sensitive to the action of medicinal substances and therefore during this period of pregnancy only harmless drugs are prescribed that do not adversely affect the fetus. In the first and second trimester of pregnancy, the spectrum of antibiotics used for treatment can be expanded. In the postpartum period, antibacterial drugs of various groups can be used, provided that the breastfeeding is suspended.
The duration of antibiotic use is determined by the nature and severity of the disease. Unreasonably long-term antibiotic therapy increases the frequency of side effects of drugs, including the development of dysbiosis, antibiotic-associated diarrhea . In most cases, antibiotics can be canceled 2–3 days after the temperature normalizes. If within 48–72 hours after the start of antibiotic therapy there is no positive dynamics of the disease, the issue of changing antibacterial drugs should be resolved (even in the absence of bacteriological examination results). However, it must be certain that the removal or surgical debridement of the foci of infection (according to indications) has been fully performed (for example, hysterectomy and drainage of the abdominal cavity during obstetric peritonitis; operation for purulent mastitis; instrumental emptying of the uterus during an infected abortion, etc.) . As you know, the causes of the ineffectiveness of antibiotic therapy can be the resistance of the pathogen to this drug, insufficient penetration of the antibiotic into the focus of inflammation, impaired immune status of the woman.
Summarizing the above, it is necessary to emphasize that antibacterial drugs are an important, often the main component of the complex therapy of infectious diseases in obstetric practice; their rational and reasonable use in most cases determines the effectiveness of the treatment, favorable obstetric and neonatal outcomes.