Erythromycin therapy in preterm premature rupture of the membranes: a prospective, randomized trial of 220 patients.
OBJECTIVE
The use of prophylactic antibiotics in the management of preterm premature rupture of the membranes has not been adequately studied. The purpose of this study was to evaluate the efficacy of oral erythromycin therapy in the prolongation of latency and reduction of infectious morbidity after preterm premature rupture of membranes.


METHODS
In this randomized, prospective, double-blind, placebo-controlled study, 220 women at 20 to 35 weeks' gestation were evaluated. Subjects received oral erythromycin 333 mg (n = 106) or indistinguishable placebo (n = 114) every 8 hours from randomization to delivery.


RESULTS
Prolongation of latency was identified with erythromycin therapy (p = 0.02), particularly for those destined to have chorioamnionitis (p = 0.003) and those with oligohydramnios (p = 0.01). No decrease in the incidence of maternal or neonatal infectious morbidity was seen.


CONCLUSIONS
Oral erythromycin delays, but does not prevent, the onset of clinical infection when administered to women with preterm premature rupture of membranes. This regimen does not decrease neonatal morbidity and mortality.
Mercer
B M
BM
Department of Obstetrics and Gynecology, University of Tennessee, Memphis 38103.
Moretti
M L
ML
Prevost
R R
RR
Sibai
B M
BM
D036861:Delivery, Obstetric; D004311:Double-Blind Method; D004917:Erythromycin / Q000627:therapeutic use*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000188:drug therapy*; D006801:Humans; D017053:Infection Control / Q000379:methods; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D013997:Time Factors; D014626:Vaginal Smears
D004917:Erythromycin