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PROPHYLAXIS WITH AZITHROMYCIN VERSUS ERYTHROMYCIN IN THE MANAGEMENT OF PRETERM PREMATURE RUPTURE OF THE MEMBRANES (PPROM): A COHORT STUDY
Abstract Number: T-27
Abstract Type: Original Research
Objective: To compare prophylactic azithromycin with that of the often unavailable ‘standard’ regimen of erythromycin in women whose singleton pregnancies are complicated by PPROM (ruptured membranes at 240 to 336 completed weeks).
Methodology: We did a retrospective cohort study of PPROM pregnancies managed at LUMC from January, 2009 to December, 2010. The study population consisted of women who were given prophylactic antibiotics. Group I received azithromycin and ampicillin/amoxicillin for seven consecutive days following PPROM (and in the absence of delivery); Group II got erythromycin and ampicillin/amoxicillin. The primary outcome of interest was latency (elapsed time between PPROM and delivery). Sentinel maternal and neonatal outcome data were also collected.
Results: Sixty singleton pregnancies (Group I, N=24 and Group II, N=36) were included in the analysis. Median gestational ages on admission were 30.2 and 29.6 weeks, respectively (p=0.98); and at delivery, were 31.5 and 30.4 weeks, respectively (p=0.95). There was no significant difference in median latencies between the two groups (Group I [azithromycin], 3.2 days vs. Group II [erythromycin], 2.8 days, p=0.90 ). In addition, by univariate analysis, there were no differences between the two groups in regard to a host of maternal and neonatal variables (see Table). In the azithromycin group, increased histologic funisitis was borderline significant.
Conclusion: In our data, mothers with PPROM who received prophylactic antibiotic regimens including azithromycin were not found to have shorter latencies than those who received erythromycin. However, the nearly significant difference (p=0.06) in histologic funisitis between the two groups warrants further investigation.