Antibiotic prophylaxis in preterm rupture of membranes

Abstract

Preterm premature rupture of membranes (PPROM) occurs before 37 weeks of gestation, accounting for approximately one-third of cases of preterm birth and increased maternal and neonatal morbidity and mortality. Several protocols recommend expectant management between 24 and 36 weeks of gestation, in order to allow acomplishment of fetal maturation and to avoid the dramatic consequences of prematurity. Despite benefits related to gestational prolongation, the most feared risk from this protocol is the increase of maternal-fetal infection. For this reason, the use of prophylactic antibiotics is recommended, although there is no consensus regarding the best choice. The objective of the present review was to analyze the impact of antibiotic prophylaxis on maternal and neonatal outcomes in cases of PPROM. It was observed that further studies are needed with the aim of standardizing the best antibiotic regimen in PPROM, as well as defining the actual maternal and neonatal outcomes, at long term, from its use.

Cefotaxime vs Ceftriaxone for the Management of Preterm Premature Rupture of Membranes

“…The difference in this use of antibiotics can be due to the administration of antibiotics adjusted to their susceptibility to the bacteria that cause infection. In the previous research, cephalosporin as first-line therapy for the care of mothers and newborns in PPROM is indicated because of the high susceptibility of Escherichia coli to antibiotics [12]. Escherichia coli was one of the most common microorganism isolated from women with PPROM along with Staphylococcus or Streptococcus species [14][15][16].…”

“…Several protocols recommend other different choices of antibiotic. Some Latin American countries recommend the use of ampicillin or amoxicillin [12]. Those antibiotics also showed a significant increase in the latency period and a lower incidence of clinical amnionitis [12,37].…”

“…Some Latin American countries recommend the use of ampicillin or amoxicillin [12]. Those antibiotics also showed a significant increase in the latency period and a lower incidence of clinical amnionitis [12,37]. But the use of ampicillin and amoxicillin was related to adverse symptoms, such as nausea, vomiting and abdominal pain [37,38].…”