Antibiotics for preterm rupture of membranes

Antibiotic administration following preterm rupture of membranes (less than 37 weeks) is associated with a delay in delivery and a reduction in markers of neonatal morbidity, but appears not to affect perinatal mortality or longer term health of children.

A Cochrane review included 22 trials involving over 6 800 women and their babies. The use of antibiotics following preterm rupture of membranes (PROM) showed a reduction in chorioamnionitis (RR 0.66, 95% CI 0.46 to 0.96, n=1 559). There was a reduction in the numbers of babies born within 48 hours (RR 0.71, 95% CI 0.58 to 0.87, I²=50%; n=5 927) and seven days (RR 0.79, 95% CI 0.71 to 0.89; statistical heterogeneity I²=65%). Neonatal morbidity was reduced: neonatal infection (RR 0.67, 95% CI 0.52 to 0.85, n=1 680), use of surfactant (RR 0.83, 95% CI 0.72 to 0.96, n=4 809), oxygen therapy (RR 0.88, 95% CI 0.81 to 0.96, n=4 809), and abnormal cerebral ultrasound scan prior to discharge from hospital (RR 0.81, 95% CI 0.68 to 0.98, n=6 289). Amoxicillin plus clavulanic acid was associated with an increased risk of neonatal necrotising enterocolitis (RR 4.72, 95% CI 1.57 to 14.23, n=1 880). No statistically significant reduction in perinatal mortality prior to discharge from hospital could be found (RR 0.87, 95% CI 0.72 to 1.05; n=6 982). One study evaluated the children's health at seven years of age (ORACLE Children Study) and found antibiotics seemed to have little effect on the health of children (RR 1.01, 95% CI 0.91 to 1.12; n=3 171).

The following decision support rules contain links to this evidence summary:

• Antibiotics for preterm rupture of membranes

Ədəbiyyat

1. Kenyon S, Boulvain M, Neilson JP. Antibiotics for preterm rupture of membranes. Cochrane Database Syst Rev 2010;(8):CD001058 [Review content assessed as up-to-date: 26 November 2013]. .