title: Antibiotic therapy for the treatment of preterm labor: a review of the evidence.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill 27599-7570, USA.
authors.forename: John M
authors.initials: JM
authors.lastname: Thorp
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Hartmann
authors.forename: Nancy D
authors.initials: ND
authors.lastname: Berkman
authors.forename: Timothy S
authors.initials: TS
authors.lastname: Carey
authors.forename: Kathleen N
authors.initials: KN
authors.lastname: Lohr
authors.forename: Norma I
authors.initials: NI
authors.lastname: Gavin
authors.forename: Vic
authors.initials: V
authors.lastname: Hasselblad
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents