BACKGROUND: Premature birth carries substantial neonatal morbidity and mortality. One cause, associated with @entity13493 of membranes (pROM), is often subclinical @entity281 . Maternal antibiotic therapy might lessen infectious morbidity and delay labour, but could suppress labour without treating underlying @entity281 . OBJECTIVES: To evaluate the immediate and long-term effects of administering antibiotics to @entity1 with pROM before 37 weeks, on maternal infectious morbidity, fetal and neonatal morbidity and mortality, and longer term childhood development. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group trials register (January 2003) and the Cochrane Controlled Trials Register (The Cochrane Library, Issue 4, 2002). SELECTION CRITERIA: Randomised controlled trials comparing antibiotic administration with placebo that reported clinically relevant outcomes, were included. In addition, trials, in which no placebo was used, were included for the outcome of perinatal @entity204 alone. DATA COLLECTION AND ANALYSIS: Data were extracted from each report without blinding of either the results or the treatments that @entity1 received. Unpublished data were sought from a number of authors. MAIN RESULTS: Nineteen trials involving over 6000 @entity1 and their babies were included. The use of antibiotics following pROM is associated with a statistically significant reduction in @entity5870 (relative risk (RR) 0.57, 95% confidence interval (CI) 0.37 to 0.86). There was a reduction in the numbers of babies born within 48 hours (RR 0.71, 95% CI 0.58 to 0.87) and seven days of randomisation (RR 0.80, 95% CI 0.71 to 0.90). The following markers of neonatal morbidity were reduced: @entity281 (RR 0.68, 95% CI 0.53 to 0.87), use of surfactant (RR 0.83, 95% CI 0.72 to 0.96), @entity26 therapy (RR 0.88, 95% CI 0.81 to 0.96), and abnormal cerebral ultrasound scan prior to discharge from hospital (RR 0.82, 95% CI 0.68 to 0.98). Co-amoxiclav was associated with an increased risk of @entity1964 (RR 4.60, 95% CI 1.98 to 10.72). REVIEWER'S CONCLUSIONS: Antibiotic administration following pROM is associated with a delay in delivery and a reduction in major markers of neonatal morbidity. These data support the routine use of antibiotics in pPROM. The choice as to which antibiotic would be preferred is less clear as, by necessity, fewer data are available. Co-amoxiclav should be avoided in @entity1 at risk of @entity3152 because of the increased risk of @entity1964 . From the available evidence, @entity2929 would seem a better choice.

Antibiotics for XXXX of membranes.

@entity1 :: ('9606', 'Species') :: ['women'] @entity3152 :: ('MESH:D007752', 'Disease') :: ['preterm delivery'] @entity26 :: ('MESH:D010100', 'Chemical') :: ['oxygen'] @entity2929 :: ('MESH:D004917', 'Chemical') :: ['erythromycin'] @entity5870 :: ('MESH:D002821', 'Disease') :: ['chorioamnionitis'] @entity281 :: ('MESH:D007239', 'Disease') :: ['neonatal infection', 'infection'] @entity1964 :: ('MESH:D004760', 'Disease') :: ['neonatal necrotising enterocolitis'] @entity13493 :: ('MESH:C563032', 'Disease') :: ['preterm rupture'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death']
@entity13493 :: (MESH:C563032,Disease) :: ['preterm rupture']
