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

Abstract

Introduction: Antibiotics are well known and recommended as the main therapy for preterm premature rupture of membranes (PPROM.) But the research on antibiotics other than the recommended macrolides regimens is still lacking. This research aims to evaluate whether there are effects differences of cefotaxime and ceftriaxone given on pregnancy with PPROM by comparing the duration of the latency period and the infants outcomes.
 Material and Methods: Data was taken retrospectively through medical records at Dr. Soetomo Surabaya General Hospital, Indonesia during the period of January-December 2017. The inclusion criteria were a history of PPROM in pregnancy <37 weeks, given cefotaxime or ceftriaxone therapy, and have labor data. The analysis was performed by the Mann-Whitney comparison test for the latency period and Fisher's exact test for infant outcomes.
 Results: There were 52 samples obtained. The antibiotics used were cefotaxime 3x1gr (A) and ceftriaxone 2x1gr (B). The results of the analysis showed that there were no significant differences between the types of antibiotics with the length of the latency period, with a value of p = 0,601 (p>0,05), where group A had a median of 52,67 hours and group B was 34,17 hours. Group A was found to be more able to extend the latency period for >48 hours with a percentage of 57,8%, whereas in group B only 42,9%. There are no significant differences in infant outcomes; infant birth weight and Apgar score among the two therapies used.
 Conclusion: Cefotaxime was more preferably to be used in the Dr. Soetomo Surabaya General Hospital. Nevertheless, ceftriaxone can still be a good choice for PPROM therapy since both cephalosporins have succeeded in preventing infections in women with PPROM.

Use of Antibiotics and Probiotic Lactobacilli in the Treatment of Preterm Premature Rupture of Membranes: a Review

“…Both antibiotics have been proven to delay preterm labor in patients with premature rupture of membranes. (Rasti et al, 2020)…”

“…Rasti et al chose these two antibiotics because they have lower side effects, minimal risk of allergies, are safe to use during pregnancy, and are more sensitive in treating bacterial infections in PROM, namely: Staphylococcus, Streptococcus dan Escherichia coli. (Rasti et al, 2020) Vaginal infections are significantly reduced with the help of probiotic therapy during pregnancy. Observational research by Kavak et al in 2014 reported that the addition of probiotics with the antibiotic ampicillin in preterm PROM patients was able to delay labor for 5 days and prevent infection.…”