[The role of antibiotics in the prevention of cross infections in newborn infants and mothers during the puerperium].

Epidemiological efficiency of antibiotic prophylaxis of hospital infections (HIs) in maternity homes was analyzed by the materials on the clinical observation of 43995 newborns and their mothers within a period of 1986 to 1989 as well as by the data on the bacteriological examination of 6616 smears from the mucosa of the nose, pharynx, rectum and umbilical wounds of 1890 newborns carried out within the same period. It was shown that the prophylactic use of the antibiotics in the maternity homes led to changes in the microflora colonizing the newborns. The more massive was the use of the antibiotics in the departments of newborns and the postnatal departments, the more intensive was replacement of gram-positive microflora in the newborns by gram-negative organisms among which Klebsiella strains with high antibiotic resistance predominated. This involved an increase in the incidence of pneumonia and sepsis in the newborns and a higher death rate among the newborns due to HIs. In parallel there was observed an increase in the incidence of metro-endometritis in the puerperae++ and a simultaneous decrease in the number of the cases with lactational mastitis as a result of lower numbers of Staphylococcus aureus cultures isolated from various loci of the newborns. It was concluded that antibiotics were not the drugs to be used as prophylactic agents in control of HIs in maternity homes.(ABSTRACT TRUNCATED AT 250 WORDS)