Antibiotic therapy in preterm premature rupture of membranes: A randomized, prospective, double-blind trial

Johnston, Matthew M.; Sánchez-Ramos, Luis; Vaughn, Arthur J.; Todd, Mark W.; Benrubi, Guy I.

doi:10.1016/0002-9378(90)91060-p

Cited by 116 publications

(34 citation statements)

References 11 publications

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“…Esse mecanismo seria incontestável se a infecção fosse apenas uma conseqüência da amniorrexe, mas estudos anteriores questionam esse fato e põem a infecção como causa da rotura das membranas 4 . Considerando a infecção como causa da amniorrexe, o PL dessas pacientes tende a ser breve.…”

Section: Recém-nascidounclassified

“…As principais repercussões maternas incluem aumento na taxa de cesárea, corioamnionite clínica e infecção pós-parto, ao passo que o risco perinatal inclui, entre outros, prematuridade, infecção, sepse neonatal e óbito fetal e neonatal [1][2][3][4][5] . Com a finalidade de obter maturidade pulmonar fetal a conduta expectante, com ou sem a utilização de corticosteróides, tem sido freqüen-temente adotada, obviamente diante dos casos bem selecionados e na ausência de contra-indicações para tal medida.…”

Section: Introductionunclassified

“…

IntroduçãoApesar dos avanços científicos e tecnológicos na vigência do terceiro milênio, a rotura prematura das membranas (RPM) continua sendo um desafio para o obstetra e certamente o será para aqueles que irão militar na especialidade no sé-culo XXI.As principais repercussões maternas incluem aumento na taxa de cesárea, corioamnionite clínica e infecção pós-parto, ao passo que o risco perinatal inclui, entre outros, prematuridade, infecção, sepse neonatal e óbito fetal e neonatal [1][2][3][4][5] . Com a finalidade de obter maturidade pulmonar fetal a conduta expectante, com ou sem a

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Morbidade Materna e Morbimortalidade Perinatal Associada à Infecção Ascendente na Rotura Prematura das Membranas

Rocha¹,

Tomaz²,

Rocha³

et al. 2002

Rev. Bras. Ginecol. Obstet.

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Section: Recém-nascidounclassified

Section: Introductionunclassified

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Morbidade Materna e Morbimortalidade Perinatal Associada à Infecção Ascendente na Rotura Prematura das Membranas

Rocha¹,

Tomaz²,

Rocha³

et al. 2002

Rev. Bras. Ginecol. Obstet.

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“…Two individual studies 46,47 (one a randomized prospective trial 47 ), as well the pooled data, indicate that antibiotic treatment of women with preterm premature rupture of membranes before delivery reduced the rate of culture-proven sepsis among their infants. In several of these studies, GBS-colonized women were excluded 48,51,52 or were given intrapartum prophylaxis. 53,55 In three trials in which intervention was not contingent on GBS colonization status, 46,50,54 there were no cases of early-onset GBS infection in 104 infants whose mothers received intrapartum antibiotics and 7 cases in 152 infants born to women who were not given antibiotics (P Ͼ .05).…”

Section: Intrapartum Treatment For Preterm Premature Rupture Of Membrmentioning

confidence: 99%

Antimicrobial Prevention of Early-onset Group B Streptococcal Sepsis: Estimates of Risk Reduction Based on a Critical Literature Review

1999

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ABSTRACT. Objective. To identify interventions that reduce the attack rate for early-onset group B streptococcal (GBS) sepsis in neonates.Study Design. Literature review and reanalysis of published data.Results. The rate of early-onset GBS sepsis in highrisk neonates can be reduced by administration of antibiotics. Treatment during pregnancy (antepartum prophylaxis) fails to reduce maternal GBS colonization at delivery. With the administration of intravenous ampicillin, the risk of early-onset infection in infants born to women with preterm premature rupture of membranes is reduced by 56% and the risk of GBS infection is reduced by 36%; addition of gentamicin may increase the efficacy of ampicillin. Treatment of women with chorioamnionitis with ampicillin and gentamicin during labor reduces the likelihood of neonatal sepsis by 82% and reduces the likelihood of GBS infection by 86%. Universal administration of penicillin to neonates shortly after birth (postpartum prophylaxis) reduces the early-onset GBS attack rate by 68% but is associated with a 40% increase in overall mortality and therefore is contraindicated. Intrapartum prophylaxis, alone or combined with postnatal prophylaxis for the infants, reduces the early-onset GBS attack rate by 80% or 95%, respectively.Conclusions. Women with chorioamnionitis or preterm premature rupture of membranes and their infants should be treated with intravenous ampicillin and gentamicin. Intrapartum antimicrobial prophylaxis may be appropriate for other women whose infants are at increased but less extreme risk, and supplemental postpartum prophylaxis may be indicated for some of their infants. Selection of appropriate candidates and prophylaxis strategies requires careful consideration of costs and benefits for each patient. Pediatrics 1999;103(6). URL: http://www.pediatrics.org/cgi/content/full/103/6/e78; group B streptococcus, neonatal sepsis, early-onset sepsis, prevention, prophylaxis.ABBREVIATIONS. EOGBS, early-onset neonatal group B streptococcus infection; AAP, American Academy of Pediatrics; ACOG, American College of Obstetricians and Gynecologists; CDC, Centers for Disease Control and Prevention; GBS, group B streptococcus. P revention of early-onset neonatal group B streptococcal (EOGBS) sepsis requires the identification of infants who are at high risk and the use of effective preventive intervention. The American Academy of Pediatrics (AAP), 1,2 American College of Obstetricians and Gynecologists (ACOG), 3,4 and Centers for Disease Control and Prevention (CDC) 5 agree that this intervention should be intrapartum antibiotic treatment. The commentaries that accompany those recommendations and several recent cost-benefit or efficacy analyses implicitly 1-7 or explicitly 8 -11 assume that intrapartum antimicrobial prophylaxis is 100% effective, but reports of at least 50 cases of EOGBS disease in infants whose mothers received intrapartum prophylaxis [12][13][14][15] demonstrate that this cannot be correct. The decision analysis cited by the CDC recommendations 1...

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“…Although several trials have shown a beneficial effect of prophylactic antibiotic therapy on maternal -fetal outcome, however the optimal drug or combination of drugs, route of administration, and duration of therapy are yet to be determined [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]. Because of the variety of potential pathogens colonizing the vagina (and possibly the amnion after membrane rupture), broad-spectrum antibiotics offer some theoretical advantages over narrow-spectrum agents.…”

Section: Introduction:-mentioning

confidence: 99%

Effect of three regimens of prophylactic antibiotics in pregnant women with preterm premature rupture of fetal membranes: A randomised comparative study.

Arora¹,

Trivedi²,

Patra³

et al. 2017

IJAR

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Antibiotic therapy in preterm premature rupture of membranes: A randomized, prospective, double-blind trial

Cited by 116 publications

References 11 publications

Morbidade Materna e Morbimortalidade Perinatal Associada à Infecção Ascendente na Rotura Prematura das Membranas

Morbidade Materna e Morbimortalidade Perinatal Associada à Infecção Ascendente na Rotura Prematura das Membranas

Antimicrobial Prevention of Early-onset Group B Streptococcal Sepsis: Estimates of Risk Reduction Based on a Critical Literature Review

Effect of three regimens of prophylactic antibiotics in pregnant women with preterm premature rupture of fetal membranes: A randomised comparative study.

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