TITLE: Randomized Trial of Antibiotics in Addition to Tocolytic Therapy to Treat Preterm Labor

  ABSTRACT:

			Objective: The objective of this study was to assess whether antibiotic 
            therapy plus tocolysis given to women in preterm labor would prolong pregnancy 
            compared with tocolysis alone.
		  
			Methods: A randomized, double-blind trial of intravenous 
            mezlocillin and oral erythromycin therapy vs. placebo was used in addition to 
            tocolysis among women in preterm labor ≤34 weeks gestation with intact 
            membranes. Amniocentesis was performed, and chorioamnionic membranes
            were examined histologically and cultured for microorganisms after delivery.
		  
			Results: Clinical characteristics including gestational age at 
            enrollment, frequency of contractions, cervical Bishop's score, and white blood 
            cell count on admission were similar in the 2 groups. Antibiotic therapy was well tolerated. 
            No significant differences in the interval to delivery, birth weight, and neonatal outcomes 
            were observed between the 2 groups. Women in the antibiotic group had a significantly 
            lower incidence of postpartum infections compared with women in the placebo group. 
            Patients with evidence of upper genital tract infection in either group had a significantly
          shorter interval to delivery, lower gestational age at delivery, lower mean birth weight, 
          and increased neonatal hospitalization time.
		  
			Conclusions: Lack of an antibiotic effect on the gestational age 
            at delivery may be due to the low prevalence of upper genital tract infection among 
            unselected women in preterm labor, to advanced preterm labor unresponsive to antibiotic 
            therapy, or to an inability of antibiotics given alone to inhibit the cytokine response. 
            Further work is needed to identify markers of upper genital tract infection
           among women in preterm labor and to evaluate other potential therapeutic interventions.

Question: Compared to placebo what was the result of antibiotic therapy on gestational age?
Answer: no significant difference