A prospective, randomized, placebo-controlled trial of penicillin in preterm premature rupture of membranes.
OBJECTIVE
Preterm premature rupture of the fetal membranes is common and frequently results in infectious complications. A prospective, randomized, controlled trial of penicillin versus placebo in preterm premature rupture of membranes is reported. The aim of the study was to determine if prophylactic antibiotics after preterm premature rupture of membranes would reduce infectious complications in the mother or neonate.


METHODS
Patients with preterm premature rupture of membranes between 21 and 37 weeks' gestation were randomized into a penicillin group that received 1 million units of benzylpenicillin intravenously every 4 hours followed by 250 mg of potassium phenoxymethyl penicillin (Pen-Vee K, Wyeth-Ayerst) orally twice daily or a placebo group before delivery. Latency period, infectious complications, and neonatal outcomes were studied.


RESULTS
Patients with preterm premature rupture of membranes who received prophylactic penicillin had fewer infectious complications, including intraamniotic infection and postpartum endometritis (4 vs 11, p < 0.03), without adverse effects on the mother or fetus.


CONCLUSIONS
Prophylactic penicillin in patients with preterm premature rupture of membranes reduces maternal infectious complications without adversely affecting the mother or newborn.
Ernest
J M
JM
Department of Obstetrics and Gynecology, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC 27157.
Givner
L B
LB
D002821:Chorioamnionitis / Q000209:etiology / Q000382:microbiology / Q000517:prevention & control*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000150:complications; D006801:Humans; D007231:Infant, Newborn; D010400:Penicillin G / Q000627:therapeutic use*; D010404:Penicillin V / Q000627:therapeutic use*; D011247:Pregnancy; D011446:Prospective Studies; D012007:Rectum / Q000382:microbiology; D013290:Streptococcal Infections / Q000382:microbiology / Q000517:prevention & control*; D013292:Streptococcus agalactiae / Q000302:isolation & purification*; D014621:Vagina / Q000382:microbiology
D010400:Penicillin G; D010404:Penicillin V