A new antibiotic regimen treats and prevents intra-amniotic inflammation/infection in patients with preterm PROM. (1st September 2016)

• Record Type: Journal Article
• Authors: Lee, JoonHo; Romero, Roberto; Kim, Sun Min; Chaemsaithong, Piya; Yoon, Bo Hyun
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 29:Number 17(2016)
• Page Start: 2727
• Page End: 2737
• Publication Date: 2016-09-01
• Subjects: Ceftriaxone -- chorioamnionitis -- clarithromycin -- erythromycin -- funisitis -- metronidazole -- neonatal morbidity -- neonatal sepsis -- pregnancy -- prematurity -- preterm birth -- preterm labor -- placental pathology; Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• DOI: 10.3109/14767058.2015.1103729
• Languages: English
• ISSNs: 1476-7058

Abstract

Abstract: Objectives : To determine whether a new antibiotic regimen could reduce the frequency of intra-amniotic inflammation/infection in patients with preterm PROM. Study design : This retrospective cohort study was conducted to evaluate the effect of antibiotics on the frequency of intra-amniotic inflammation/infection based on the results of follow-up transabdominal amniocenteses from 89 patients diagnosed with preterm PROM who underwent serial amniocenteses. From 1993–2003, ampicillin and/or cephalosporins or a combination was used ("regimen 1"). A new regimen (ceftriaxone, clarithromycin and metronidazole) was used from 2003–2012 ("regimen 2"). Amniotic fluid was cultured and matrix metalloproteinase-8 (MMP-8) concentrations were measured. Results : (1) The rates of intra-amniotic inflammation and intra-amniotic inflammation/infection in patients who received regimen 2 decreased during treatment from 68.8% to 52.1% and from 75% to 54.2%, respectively. In contrast, in patients who received regimen 1, the frequency of intra-amniotic inflammation and infection/inflammation increased during treatment (31.7% to 55% and 34.1% to 58.5%, respectively); and (2) intra-amniotic inflammation/infection was eradicated in 33.3% of patients who received regimen 2, but in none who received regimen 1. Conclusion : The administration of ceftriaxone, clarithromycin and metronidazole was associated with a more successful eradication of intra-amniotic inflammation/infection and prevented secondary intra-amniotic inflammation/infection more frequently than an antibiotic regimen which included ampicillin and/or cephalosporins in patients with preterm PROM.