Randomized Controlled Trial on the Effects of Different Antibiotic Regimens in Preterm Premature Rupture of Membranes After 34 Weeks

Abstract

Background: To investigate the effects of different antibiotic regimens used in the treatment of preterm premature rupture of membranes (PPROM) on maternal and fetal outcomes after 34 weeks of gestation. Methods: A total of 40 pregnant women diagnosed with PPROM between 34 and 37 weeks of gestation were enrolled in this randomized controlled trial and allocated equally into 2 groups. Group 1 received sulbactam-ampicillin, azithromycin, and amoxicillin, whereas Group-2 received ceftriaxone, clarithromycin, and amoxicillin. The primary outcome was neonatal intensive care unit (NICU) length of stay. Recorded variables included maternal age, gestational age, obstetric history, time of delivery, latency period, infection markers (white blood cell count and C-reactive protein), neonatal birth weight, Apgar scores, NICU admission, mode of delivery, and maternal complications. Statistical analyses were performed using IBM SPSS Statistics for Windows, Version 27.0 (Armonk). Results: No statistically significant differences were observed between the groups in terms of age, obstetric age, obstetric history, time of delivery, infection markers (white blood cell, C-reactive protein), and type of delivery (P > .05). The difference between the groups in terms of NICU requirement and stay duration was not statistically significant; Group 1: mean 8.3 +/- 6.7 days and Group 2: 4.3 +/- 1.9 days (P = .356). The incidence of maternal complications showed no statistically significant difference; chorioamnionitis was observed in 4 patients (20.0%) in Group 1 and in a patient (5.0%) in Group 2 (P = .141). No difference was observed type of delivery and history of PPROM. Conclusion: The 2 different antibiotic regimens administered to pregnant women diagnosed with PPROM after the 34th week of gestation demonstrated similar clinical effects in terms of maternal and neonatal outcomes. Although the differences in NICU stay duration and the number of chorioamnionitis cases were not statistically significant, we believe that these findings could reach significance in studies with larger sample sizes.