Antibiotic treatment of intra-amniotic infection with Ureaplasma urealyticum. A case report and literature review.
BACKGROUND
Ureaplasma urealyticum is the most common pathogen cultured from the amniotic cavity of women with preterm labor and intact membranes. However, experience with antibiotic eradication of the pathogen in this setting is limited.


METHODS
We report a case of U. urealyticum isolation from the amniotic cavity of a woman with preterm labor at 27 weeks gestation. The patient was treated with erythromycin base for 1 week, followed by fluoroquinolones and clindamycin for 10 days. A healthy neonate was delivered after spontaneous labor began at 33 weeks. The cultures obtained from the placenta and membranes were sterile, but the histopathology of the placenta revealed acute chorioamnionitis with acute funisitis.


CONCLUSIONS
We suggest that intra-amniotic colonization with Mycoplasma spp. remote from term may be managed expectantly, and that therapy with fluoroquinolones and/or clindamycin may be an appropriate choice.
Smorgick
Noam
N
Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Zerifin, Israel. noam_yossi@yahoo.com
Frenkel
Eugenia
E
Zaidenstein
Ronit
R
Lazarovitch
Tsilia
T
Sherman
Dan J
DJ
D000208:Acute Disease; D000328:Adult; D000653:Amniotic Fluid / Q000382:microbiology*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002821:Chorioamnionitis / Q000188:drug therapy* / Q000382:microbiology; D002981:Clindamycin / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004917:Erythromycin / Q000627:therapeutic use; D005260:Female; D024841:Fluoroquinolones / Q000627:therapeutic use; D005865:Gestational Age; D006801:Humans; D050498:Live Birth; D007752:Obstetric Labor, Premature / Q000382:microbiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000382:microbiology; D016869:Ureaplasma Infections / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology; D016990:Ureaplasma urealyticum / Q000302:isolation & purification*
D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D002981:Clindamycin; D004917:Erythromycin