PROPHYLACTIC ADMINISTRATION OF AMOXICILLIN AND CLAVULANIC ACID IN PREGNANT-WOMEN WITH PREMATURE RUPTURE OF THE MEMBRANES

Seventy-five pregnant women (mean gestational age 32.26 weeks, range 2 0-36 weeks) with premature rupture of the membranes (FROM) were admitt ed in our department during 1989 and the first 6 months of 1990. Amoxi cillin and clavulanic acid was initially administered at a dose of 1.2 g i.v. every 8 hours for 3-4 days and was followed by oral administra tion of 625 mg every 8 hours until labor. Sixty-one patients (mean ges tational age 32.6+/-2.3 weeks, range 26-36 weeks) achieved an uncompli cated course of their pregnancies with a mean time of 11.4+/-5.7 days (range 3-27 days), from rupture to delivery. Fourteen women (mean gest ational age 30.8+/-5 weeks, range 20-36 weeks) developed chorioamnioni tis 3.5+/-0.9 days (range 1.4-5.6 days) after the rupture with several degrees of leukocyte infiltration of the membranes, placenta and the umbilical cord. Five women (mean gestational age 23.8+/-2.3 weeks, ran ge 20-26 weeks) had complications resulting in fetal/infant death, thr ee of them because of fetal sepsis (Escherichia coli, Pseudomonas aero ginosa, Staphylococcus aureus). The newborns were followed up 6 months from delivery and had no signs of drug influence. Few side effects we re observed with the chief complaints involving the gastrointestinal t ract (4%). No one discontinued the drug. It seems therefore, that the prophylactic administration of amoxicillin and cluvalanic acid in wome n with FROM is associated with a significant prolongation of pregnancy and with a reduction in the incidence of fetal/maternal infections.