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In the timing of perioperative antibiotic use in planned abdominal surgery until there is no consensus, and it is a matter of debate. There are several time slots duration of antibiotic treatment in the postoperative period. According to MI Cousin et al. [17], the net transactions using a single prednarkoznoe antibiotics. Ultra-short course (24 hours) with the introduction of mandatory prednarkoznym recommended for conditionally-clean operation, and in special readings - with clean operations. Short-term prophylaxis (48-72 hours) is more often used in contaminated operations, and in some cases - if conditionally clean. Long-term antibiotic prophylaxis (over 3 days) is used in "dirty" and "dirty" operations.

Antibiotic prophylaxis of not more than 24 hours is considered by some authors as the optimal time. When extending the temporal range of antibiotics is regarded as antimicrobial therapy [61.66].

According to MI Cousin et al. [28], the optimal period of prophylactic antibiotics in abdominal operations are 48-72 hours with a mandatory prednarkoznym drug administration. At the same time we can not exclude the extension of this period, which is determined by the specific clinical situation.

Important for prevention is the choice of antimicrobial agent. Benchmarks are accounting nature microflora, vegetative in an operated organ, as well as complete information on hospital strains of this hospital. Under these conditions of choice are broad-spectrum antibiotics that can effectively influence the potential pathogen. When choosing an antibiotic one of the important conditions is to ensure a sufficient concentration in the blood and tissues of the operated organ for the whole period of surgery. Antibiotic should have minimal toxicity. The drug should be optimal from the standpoint of cost-effectiveness.

The most important principle in the appointment of an antimicrobial drug - knowing whether or not during the upcoming elective surgery carried out access to parts of the body, which was significantly colonized by obligate anaerobes (Bacteroides spp.). If it is assumed the presence of anaerobic microorganisms, for example, during operations on the colon, distal ileum or an appendectomy, should be used antibacterial drugs effective against Bacteroides spp. [18].

When choosing the dose of antibiotic should be a basic condition for ensuring a sufficient concentration in the blood and tissues. Should strive to achieve a concentration of 2-3 times the MIC for the likely causative agent. The choice of route of administration of the antibiotic produced, depending on the clinical situation. Intravenous administration provides rapid creation of high drug concentrations in blood and tissues.

At the same time with intramuscular antibiotics longer retained in the tissues, creating a depot for their gradual entry into the blood.

In connection with the quite natural question arises, what brand viagra antimicrobial drugs should be used as a prophylactic measure. Currently there is no unified schemes. No single antibiotic can not ensure the prevention of all types of surgical infection. Any of the schemes of antibiotic prophylaxis may be ineffective if you do not take into account the risk factors for postoperative septic complications, as well as microbiological landscape of hospital flora, which is unique for each surgical hospital. Obvious desirability of the form of antimicrobial agents for every surgical clinic.

Analysis of the results of our study of more than 1500 patients allowed to note that net transactions without the use of antibiotics, abscesses occurred in 1.4% of cases and in operations of this group after the appointment of a single dose of drugs suppuration were observed.

If conditionally clean operations in the application of antibiotics the number of suppuration was 3,3% compared with 10,1% of suppuration without antibiotics.

When "dirty" operations per cent of suppuration in prophylactic use of antibiotics observed in 7.3% of patients compared to 21.8% when antibiotic prophylaxis was not performed.

In conclusion, it should be noted that the prophylactic use of antibiotics in planned abdominal surgery is an important component of improving the results of surgical intervention and reduce the length of stay of patients in the surgical clinic.

The basic principle of perioperative antibiotic prophylaxis is the purpose of broad-spectrum drugs in adequate doses. When selecting an antimicrobial drug should take into account not only the patient's condition, but also factors of surgical aggression.

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