[A case study regarding the use of antibiotic therapies for the treatment of preterm premature rupture of fetal membranes, and emergence of antibiotic resistant bacteria].
OBJECTIVE
The objective of this retrospective study is to compare two types of antimicrobial management used to treat premature rupture of membranes in pregnancy. This study evaluates both duration and the type of antibiotic therapy used for treatment.


METHODS
The antimicrobials used to treat premature rupture of membranes include a first generation cephalosporin in one group and amoxicillin in the other group. Cephalosporin was used over a 7-day period to treat 38 cases, whereas amoxicillin was used through delivery in 52 cases. Emergence of multidrug-resistant Gram negative bacteria (GNB) on maternal of neonatal sampling was the primary outcome.


RESULTS
Emergence of antibiotic resistant GNB can be seen under both antibiotic regimens and appears to be linked to the duration of latency, and to duration of antibiotic treatment. Other outcomes (duration of latency period, gestational age at delivery, maternal and neonatal complications) were similar in both groups.


CONCLUSIONS
Antibiotic treatment in PPROM favors a selection of GNB. This emergence is positively linked with the duration of latency between rupture of membranes and delivery and with the length of antibiotic administration. The extension of antibiotherapy does not alter other maternal or neonatal parameters.
Pôle parent-enfant, service de gynécologie et obstétrique, CHU de Pointe-à-Pitre/Abymes, route de Chauvel, 97159 Pointe-à-Pitre cedex, Guadeloupe. Electronic address: xavier.legros@hotmail.fr.
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X
Legros
Maison de la Femme de la Mère et de l'Enfant (Fort-de-France), La Meynard, 97261 Fort-de-France cedex, Martinique.
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JL
Voluménie
Pôle parent-enfant, service de gynécologie et obstétrique, CHU de Pointe-à-Pitre/Abymes, route de Chauvel, 97159 Pointe-à-Pitre cedex, Guadeloupe.
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E
Janky
Pôle parent-enfant, service de gynécologie et obstétrique, CHU de Pointe-à-Pitre/Abymes, route de Chauvel, 97159 Pointe-à-Pitre cedex, Guadeloupe; Inserm U1085, IRSET, faculté de médecine, campus de Fouillole, Institut national de la santé et de la recherche médicale, 97154 Pointe-à-Pitre cedex, Guadeloupe.
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P
Kadhel
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000009:adverse effects / Q000706:statistics & numerical data* / Q000639:trends; D021821:Communicable Diseases, Emerging / Q000453:epidemiology; D024881:Drug Resistance, Bacterial; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000188:drug therapy* / Q000453:epidemiology; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology; D019430:Guadeloupe / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D008395:Martinique / Q000453:epidemiology; D011247:Pregnancy; D012189:Retrospective Studies
D000900:Anti-Bacterial Agents
Antibiotherapy; Antibiothérapie; Bacilles Gram négatifs; Gram negative bacilli (GNB); Premature preterm rupture of the membranes (PPROM); Rupture prématurée des membranes avant terme