A retrospective review of ampicillin-sulbactam and amoxicillin + clavulanate vs cefazolin/cephalexin and erythromycin in the setting of preterm premature rupture of membranes: maternal and neonatal outcomes
The purpose of this study was to compare the efficacy and outcomes of 2 different antibiotic regimens that are used to prolong latency in preterm premature rupture of membranes. The primary objective was to determine whether the use of ampicillin-sulbactam/amoxicillin + clavulanate was associated wi...
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| Published in | American journal of obstetrics and gynecology Vol. 198; no. 5; pp. e54 - e56 |
|---|---|
| Main Authors | , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Mosby, Inc
01.05.2008
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0002-9378 1097-6868 1097-6868 |
| DOI | 10.1016/j.ajog.2007.12.022 |
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| Abstract | The purpose of this study was to compare the efficacy and outcomes of 2 different antibiotic regimens that are used to prolong latency in preterm premature rupture of membranes. The primary objective was to determine whether the use of ampicillin-sulbactam/amoxicillin + clavulanate was associated with an increased risk of necrotizing enterocolitis.
A retrospective review of pregnancies that were complicated by preterm premature rupture of membranes from 1999-2006 at 2 institutions was performed. Outcomes were compared between subjects who received parenteral ampicillin-sulbactam followed by oral amoxicillin + clavulanate (protocol A) and subjects who received parenteral cefazolin and erythromycin followed by oral cephalexin and erythromycin (protocol B).
There were 147 women who were evaluated; 88 women received protocol A, and 59 women received protocol B. There were no differences in latency period, gestational age at delivery, or route of delivery. The incidence of necrotizing enterocolitis was 8.0% and 10.2% for protocol A and protocol B, respectively (
P = .64).
Ampicillin-sulbactam/amoxicillin + clavulanate was not associated with an increase in neonatal necrotizing enterocolitis. Erythromycin in combination with cefazolin and cephalexin is an effective latency antibiotic regimen. |
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| AbstractList | The purpose of this study was to compare the efficacy and outcomes of 2 different antibiotic regimens that are used to prolong latency in preterm premature rupture of membranes. The primary objective was to determine whether the use of ampicillin-sulbactam/amoxicillin + clavulanate was associated with an increased risk of necrotizing enterocolitis.
A retrospective review of pregnancies that were complicated by preterm premature rupture of membranes from 1999-2006 at 2 institutions was performed. Outcomes were compared between subjects who received parenteral ampicillin-sulbactam followed by oral amoxicillin + clavulanate (protocol A) and subjects who received parenteral cefazolin and erythromycin followed by oral cephalexin and erythromycin (protocol B).
There were 147 women who were evaluated; 88 women received protocol A, and 59 women received protocol B. There were no differences in latency period, gestational age at delivery, or route of delivery. The incidence of necrotizing enterocolitis was 8.0% and 10.2% for protocol A and protocol B, respectively (
P = .64).
Ampicillin-sulbactam/amoxicillin + clavulanate was not associated with an increase in neonatal necrotizing enterocolitis. Erythromycin in combination with cefazolin and cephalexin is an effective latency antibiotic regimen. The purpose of this study was to compare the efficacy and outcomes of 2 different antibiotic regimens that are used to prolong latency in preterm premature rupture of membranes. The primary objective was to determine whether the use of ampicillin-sulbactam/amoxicillin + clavulanate was associated with an increased risk of necrotizing enterocolitis.OBJECTIVEThe purpose of this study was to compare the efficacy and outcomes of 2 different antibiotic regimens that are used to prolong latency in preterm premature rupture of membranes. The primary objective was to determine whether the use of ampicillin-sulbactam/amoxicillin + clavulanate was associated with an increased risk of necrotizing enterocolitis.A retrospective review of pregnancies that were complicated by preterm premature rupture of membranes from 1999-2006 at 2 institutions was performed. Outcomes were compared between subjects who received parenteral ampicillin-sulbactam followed by oral amoxicillin + clavulanate (protocol A) and subjects who received parenteral cefazolin and erythromycin followed by oral cephalexin and erythromycin (protocol B).STUDY DESIGNA retrospective review of pregnancies that were complicated by preterm premature rupture of membranes from 1999-2006 at 2 institutions was performed. Outcomes were compared between subjects who received parenteral ampicillin-sulbactam followed by oral amoxicillin + clavulanate (protocol A) and subjects who received parenteral cefazolin and erythromycin followed by oral cephalexin and erythromycin (protocol B).There were 147 women who were evaluated; 88 women received protocol A, and 59 women received protocol B. There were no differences in latency period, gestational age at delivery, or route of delivery. The incidence of necrotizing enterocolitis was 8.0% and 10.2% for protocol A and protocol B, respectively (P = .64).RESULTSThere were 147 women who were evaluated; 88 women received protocol A, and 59 women received protocol B. There were no differences in latency period, gestational age at delivery, or route of delivery. The incidence of necrotizing enterocolitis was 8.0% and 10.2% for protocol A and protocol B, respectively (P = .64).Ampicillin-sulbactam/amoxicillin + clavulanate was not associated with an increase in neonatal necrotizing enterocolitis. Erythromycin in combination with cefazolin and cephalexin is an effective latency antibiotic regimen.CONCLUSIONAmpicillin-sulbactam/amoxicillin + clavulanate was not associated with an increase in neonatal necrotizing enterocolitis. Erythromycin in combination with cefazolin and cephalexin is an effective latency antibiotic regimen. The purpose of this study was to compare the efficacy and outcomes of 2 different antibiotic regimens that are used to prolong latency in preterm premature rupture of membranes. The primary objective was to determine whether the use of ampicillin-sulbactam/amoxicillin + clavulanate was associated with an increased risk of necrotizing enterocolitis. A retrospective review of pregnancies that were complicated by preterm premature rupture of membranes from 1999-2006 at 2 institutions was performed. Outcomes were compared between subjects who received parenteral ampicillin-sulbactam followed by oral amoxicillin + clavulanate (protocol A) and subjects who received parenteral cefazolin and erythromycin followed by oral cephalexin and erythromycin (protocol B). There were 147 women who were evaluated; 88 women received protocol A, and 59 women received protocol B. There were no differences in latency period, gestational age at delivery, or route of delivery. The incidence of necrotizing enterocolitis was 8.0% and 10.2% for protocol A and protocol B, respectively (P = .64). Ampicillin-sulbactam/amoxicillin + clavulanate was not associated with an increase in neonatal necrotizing enterocolitis. Erythromycin in combination with cefazolin and cephalexin is an effective latency antibiotic regimen. Objective The purpose of this study was to compare the efficacy and outcomes of 2 different antibiotic regimens that are used to prolong latency in preterm premature rupture of membranes. The primary objective was to determine whether the use of ampicillin-sulbactam/amoxicillin + clavulanate was associated with an increased risk of necrotizing enterocolitis. Study Design A retrospective review of pregnancies that were complicated by preterm premature rupture of membranes from 1999-2006 at 2 institutions was performed. Outcomes were compared between subjects who received parenteral ampicillin-sulbactam followed by oral amoxicillin + clavulanate (protocol A) and subjects who received parenteral cefazolin and erythromycin followed by oral cephalexin and erythromycin (protocol B). Results There were 147 women who were evaluated; 88 women received protocol A, and 59 women received protocol B. There were no differences in latency period, gestational age at delivery, or route of delivery. The incidence of necrotizing enterocolitis was 8.0% and 10.2% for protocol A and protocol B, respectively ( P = .64). Conclusion Ampicillin-sulbactam/amoxicillin + clavulanate was not associated with an increase in neonatal necrotizing enterocolitis. Erythromycin in combination with cefazolin and cephalexin is an effective latency antibiotic regimen. |
| Author | McNulty, Jennifer A. Clock, Charlotte A. Wing, Deborah A. Chung, Judith H. Ehsanipoor, Robert M. |
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| Cites_doi | 10.1016/S0140-6736(00)04233-1 10.1001/jama.1997.03550120049032 10.1097/01.ogx.0000137610.33201.a4 10.1016/S0002-9378(99)70017-7 10.1016/S0002-9378(97)70398-3 10.1016/0002-9378(95)91246-0 |
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| References_xml | – start-page: 1263 year: 2004 end-page: 1301 ident: bib7 article-title: Identification and management of problems in the high-risk neonate publication-title: Maternal fetal medicine: principles and practice – volume: 176 start-page: 1030 year: 1997 end-page: 1038 ident: bib4 article-title: A prospective, double-blind, randomized, controlled clinical trial of ampicillin-sulbactam for preterm premature rupture of membranes in women receiving antenatal corticosteroid therapy publication-title: Am J Obstet Gynecol – volume: 172 start-page: 412 year: 1995 ident: bib5 article-title: Ruptured membranes at 24 to 29 weeks: a randomized double blind trial of antimicrobials versus placebo publication-title: Am J Obstet Gynecol – volume: 59 start-page: 669 year: 2004 end-page: 677 ident: bib1 article-title: An evidence-based approach to the evaluation and treatment of premature rupture of membranes: part I publication-title: Obstet Gynecol Surv – volume: 278 start-page: 989 year: 1997 end-page: 995 ident: bib2 article-title: Antibiotic therapy for reduction of infant morbidity after preterm premature rupture of the membranes; a randomized controlled trial: National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network publication-title: JAMA – volume: 180 start-page: 1345 year: 1999 end-page: 1348 ident: bib3 article-title: Neonatal sepsis and death caused by resistant publication-title: Am J Obstet Gynecol – volume: 357 start-page: 979 year: 2001 end-page: 988 ident: bib6 article-title: Broad-spectrum antibiotics for preterm, prelabour rupture of fetal membranes: the ORACLE I randomised trial publication-title: Lancet – volume: 357 start-page: 979 year: 2001 ident: 10.1016/j.ajog.2007.12.022_bib6 article-title: Broad-spectrum antibiotics for preterm, prelabour rupture of fetal membranes: the ORACLE I randomised trial publication-title: Lancet doi: 10.1016/S0140-6736(00)04233-1 – start-page: 1263 year: 2004 ident: 10.1016/j.ajog.2007.12.022_bib7 article-title: Identification and management of problems in the high-risk neonate – volume: 278 start-page: 989 year: 1997 ident: 10.1016/j.ajog.2007.12.022_bib2 article-title: Antibiotic therapy for reduction of infant morbidity after preterm premature rupture of the membranes; a randomized controlled trial: National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network publication-title: JAMA doi: 10.1001/jama.1997.03550120049032 – volume: 59 start-page: 669 year: 2004 ident: 10.1016/j.ajog.2007.12.022_bib1 article-title: An evidence-based approach to the evaluation and treatment of premature rupture of membranes: part I publication-title: Obstet Gynecol Surv doi: 10.1097/01.ogx.0000137610.33201.a4 – volume: 180 start-page: 1345 year: 1999 ident: 10.1016/j.ajog.2007.12.022_bib3 article-title: Neonatal sepsis and death caused by resistant Escherichia coli: possible consequences of extended maternal ampicillin administration publication-title: Am J Obstet Gynecol doi: 10.1016/S0002-9378(99)70017-7 – volume: 176 start-page: 1030 year: 1997 ident: 10.1016/j.ajog.2007.12.022_bib4 article-title: A prospective, double-blind, randomized, controlled clinical trial of ampicillin-sulbactam for preterm premature rupture of membranes in women receiving antenatal corticosteroid therapy publication-title: Am J Obstet Gynecol doi: 10.1016/S0002-9378(97)70398-3 – volume: 172 start-page: 412 year: 1995 ident: 10.1016/j.ajog.2007.12.022_bib5 article-title: Ruptured membranes at 24 to 29 weeks: a randomized double blind trial of antimicrobials versus placebo publication-title: Am J Obstet Gynecol doi: 10.1016/0002-9378(95)91246-0 |
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| SubjectTerms | Adult Ampicillin - administration & dosage Anti-Bacterial Agents - administration & dosage Antibiotic Prophylaxis Cefazolin - administration & dosage Cephalexin - administration & dosage Chorioamnionitis - epidemiology Chorioamnionitis - prevention & control Clavulanic Acid - administration & dosage Drug Therapy, Combination Endometritis - epidemiology Endometritis - prevention & control Enterocolitis, Necrotizing - epidemiology Erythromycin - administration & dosage Female Fetal Membranes, Premature Rupture - drug therapy Humans latency antibiotic regimen necrotizing enterocolitis Obstetrics and Gynecology Pregnancy Pregnancy Outcome preterm premature rupture of membranes Retrospective Studies Sulbactam - administration & dosage |
| Title | A retrospective review of ampicillin-sulbactam and amoxicillin + clavulanate vs cefazolin/cephalexin and erythromycin in the setting of preterm premature rupture of membranes: maternal and neonatal outcomes |
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