Antibiotic Prophylaxis in Premature Rupture of Membranes at Term: A Randomized Controlled Trial

• Published in: Obstetrics and gynecology (New York. 1953) Vol. 120; no. 5; pp. 1045 - 1051
• Main Authors: PASSOS, Filipa, CARDOSO, Kátia, COELHO, Ana Maria, GRACA, André, CLODE, Nuno, MENDES DA GRACA, Luis
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 01.11.2012
• Subjects: Adolescent; Adult; Anti-Bacterial Agents - therapeutic use; Antibacterial agents; Antibiotic Prophylaxis - methods; Antibiotics. Antiinfectious agents. Antiparasitic agents; Biological and medical sciences; Chorioamnionitis - drug therapy; Chorioamnionitis - prevention & control; Delivery. Postpartum. Lactation; Diseases of mother, fetus and pregnancy; Disorders; Endometritis - drug therapy; Endometritis - prevention & control; Female; Fetal Membranes, Premature Rupture - microbiology; Gynecology. Andrology. Obstetrics; Humans; Infant, Newborn; Medical sciences; Pharmacology. Drug treatments; Pregnancy; Pregnancy Complications, Infectious - prevention & control; Pregnancy. Fetus. Placenta; Young Adult; Prevention; Chemoprophylaxis; Randomization; Pregnancy disorders; Gynecology; Premature rupture of membrane; Delivery disorders; Clinical trial; Antibacterial agent; Obstetrics
• ISSN: 0029-7844; 1873-233X
• DOI: 10.1097/AOG.0b013e31826e46bc

To determine whether prophylactic antibiotic administration in women presenting with premature rupture of membranes (PROM) at term can alter the rates of maternal and neonatal infections. In a randomized, controlled, nonblinded trial, women at low risk with singleton term pregnancies presenting with PROM were assigned to either antibiotic administration or no treatment. Main outcomes evaluated were rates of maternal infection (chorioamnionitis and endometritis) and neonatal infection. A total of 161 patients were evaluated, 78 in the antibiotic group and 83 in the control group. Maternal infection was significantly lower when antibiotics were administered (2.6% compared with 13.2%; relative risk 0.89, 95% confidence interval 0.81-0.98; P=.013). All cases of maternal infection occurred in women with more than 12 hours of PROM. Newborns of mothers receiving antibiotics had fewer infections (3.8%) compared with those in the control group (6.0%), but the difference was not statistically significant (P=.375). Prophylactic use of antibiotics in PROM at term significantly reduced the risk of maternal infection in our population. ClinicalTrials.gov, www.clinicaltrials.gov, NCT01633294. I.