Use of microbial cultures and antibiotics in the prevention of infection-associated preterm birth.
OBJECTIVE
The purpose of this study was to summarize recent evidence regarding infection-associated preterm birth and to make appropriate recommendations. Antepartum treatment of lower genital tract infection or bacterial colonization has been found to reduce the incidence of preterm birth in the case of asymptomatic bacteriuria and bacterial vaginosis in selected patients but has been proved to be ineffective for vaginal colonization with organisms such as Ureaplasma urealyticum and group B streptococcus.


METHODS
This is a clinical opinion based on a review of recent data related to 1) the association between lower genital tract infection and preterm birth and 2) antibiotic trials to prevent preterm birth.


RESULTS
Antepartum treatment of lower genital tract infection or bacterial colonization has been found to reduce the incidence of preterm birth in the case of asymptomatic bacteriuria and bacterial vaginosis in selected patients, but has been proven to be ineffective for vaginal colonization with organisms such as Ureaplasma urealyticum and group B streptococcus. Large well-designed trials have shown that the routine administration of antibiotics to women with preterm labor and intact membranes is not beneficial; however, antibiotic regimens including macrolides are recommended for preterm premature rupture of the membranes.


CONCLUSIONS
Large well-designed trials have shown that the routine administration of antibiotics to women with preterm labor and intact membranes is not beneficial; however, antibiotic regimens that include macrolides are recommended for preterm premature rupture of the membranes.
Department of Obstetrics and Gynecology, University of Colorado Health Sciences Center, Denver, USA.
Laura L
LL
Klein
Ronald S
RS
Gibbs
D000900:Anti-Bacterial Agents; D002986:Clinical Trials as Topic; D015169:Colony Count, Microbial; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008826:Microbial Sensitivity Tests; D007752:Obstetric Labor, Premature / Q000517:prevention & control*; D011181:Postnatal Care; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000382:microbiology; D011256:Pregnancy Outcome; D011295:Prenatal Care; D011379:Prognosis; D018570:Risk Assessment; D016896:Treatment Outcome; D016585:Vaginosis, Bacterial / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology
D000900:Anti-Bacterial Agents