Antibiotic therapy for the treatment of preterm labor: a review of the evidence.
OBJECTIVE
The purpose of this study was to evaluate the evidence regarding antibiotics for the treatment of preterm labor.


METHODS
Through dual review, we abstracted study design and masking, definitions of preterm labor and pregnancy outcome, patient inclusion/exclusion characteristics, patient demographic characteristics, drug and cointerventions, and numerous birth, maternal, and neonatal outcome measures. We graded the quality of the individual articles and the strength of the evidence for antibiotic benefit.


RESULTS
We abstracted data from 14 randomized trials and 1 observational study. Of these studies, 13 trials met the requirements for a meta-analysis. The meta-analysis demonstrated a mixed outcome pattern with small improvements in pregnancy prolongation, estimated gestational age at birth, and birth weight. Data were insufficient to show a beneficial effect on neonatal morbidity or mortality rates.


CONCLUSIONS
Treatment of preterm labor with antibiotic therapy can prolong gestation. The benefits of antibiotics are small, and there is considerable uncertainty about the optimal agent, route, dosage, and duration of therapy.
Thorp
John M
JM
Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill 27599-7570, USA.
Hartmann
Katherine E
KE
Berkman
Nancy D
ND
Carey
Timothy S
TS
Lohr
Kathleen N
KN
Gavin
Norma I
NI
Hasselblad
Vic
V
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001724:Birth Weight; D005260:Female; D005865:Gestational Age; D006801:Humans; D007743:Labor, Obstetric; D007752:Obstetric Labor, Premature / Q000188:drug therapy*; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic
D000900:Anti-Bacterial Agents