Abstract
Objective To compare ampicillin with and without sulbactam with respect to the effect on the latency period after preterm premature rupture of membranes (PROM).
Methods Patients with PROM at 25-35 weeks' gestation were offered participation in a randomized blinded trial comparing ampicillin-sulbactam with ampicillin. Evaluations for cervical pathogens were performed on admission and patients were followed-up with daily maternal and fetal evaluation. Maternal and neonatal outcomes were analyzed using indicated techniques.
Results Fifty-three women were studied, with 25 receiving ampicillin-sulbactam and 28 receiving ampicillin. The ampicillin-sulbactam group had a significantly longer latency period (433 +/- 625 versus 143 +/- 165 hours, P = .03) and significantly fewer neonatal complications (five versus 20, P < .001). Although no neonatal infectious complications were observed in sulbactam-treated cases, there were four cases of neonatal sepsis and two of neonatal pneumonia in the ampicillin group. Also, significantly more neonates in the ampicillin group required prolonged oxygen and ventilatory support. There was no significant difference in maternal morbidity.
Conclusions In our population with preterm PROM, a broad-spectrum antibiotic that provides anaerobic coverage appears to extend latency and decrease neonatal morbidity without increasing adverse maternal outcome.
preterm premature rupture membranes antibiotics, PPROM ampicillin sulbactam, latency period preterm PROM, neonatal sepsis prevention PPROM, antibiotic therapy preterm membrane rupture, broad spectrum antibiotics pregnancy, neonatal outcomes preterm PROM, anaerobic coverage PPROM management
Keywords
Adult, Ampicillin/therapeutic Use, Double-Blind Method, Drug Combinations, Female, Fetal Membranes, Premature Rupture/complications/drug Therapy, Follow-Up Studies, Humans, Infant, Newborn, Pneumonia/microbiology, Pregnancy, Pregnancy Complications, Infectious/microbiology, Pregnancy Outcome, Sepsis/microbiology, Sulbactam/therapeutic Use, Uterine Cervical Diseases/complications/microbiology, Drug Combinations, Ampicillin, Sulbactam,