Antibiotic treatment of patients with term Premature Rupture Of Membranes: A randomized clinical trial

Abstract

Background/objective: Subclinical microbial invasion of the amniotic cavity in patients with premature rupture of membranes (PROM) at term occurs in 34% of cases and is a risk factor for puerperal endometritis. This study was conducted to determine whether antibiotic administration to women with PROM at term could reduce the rate of infection-related morbidity. Study design: Between August 1990 and December 1993, patients with term PROM were randomly allocated to receive either cefuroxime-clindamicin or placebo. Results: Fifty five patients received intravenous antibiotics and 50 patients received placebo. Patients allocated to the antibiotic group had a lower incidence of maternal infection-related morbidity (clinical chorioamnionitis and puerperal endometritis) than patients who received placebo [1.8% (1/55) vs. 16% (8/50) respectively, p<0.05]. No significant differences were found other maternal and neonatal outcomes between the two groups. Conclusion: Administration of antibiotics to patients with PROM at term results in a significant reduction in the rate of maternal infection-related morbidity.