Effect of antibiotic therapy in preterm premature rupture of the membraneson neonatal mortality and morbidity

The objective of this study was to evaluate the effect of prophylactic anti biotic treatment on prenatal and neonatal outcome after preterm premature r upture of the membranes (P-PROM). The study population consisted of 172 pre gnant women admitted to the Rabin Medical Center in Israel with P-PROM at 2 3-34 gestational weeks. The patients were divided into two groups by mode o f expectant management-prophylactic ampicillin and erythromycin (study grou p, n = 121) or observation only (control group, n = 51) and compared for ne onatal outcome. There were no significant differences between the groups in age, gravidity, parity or gestational age at admission. Significantly more women in the study group had an interval of more than 24 hours from onset of P-PROM to delivery (98 women, 81%) than the control group (32 women, 63% ) (p = 0.001). The neonatal mortality rate was significantly lower in the s tudy group (6.6%) than the control group (17.6%) (p = 0.03). The lower neon atal mortality rate associated with prophylactic antibiotic treatment in P- PROM has important clinical implications for the effectiveness of this type of management.