title: Antibiotic Therapy Increases the Risk of Preterm Birth in Preterm Labor without Intra-Amniotic Microbes, but may Prolong the Gestation Period in Preterm Labor with Microbes, Evaluated by Rapid and High-Sensitive PCR System.
abstract: OBJECTIVE
  To examine the efficacy of the use of antibiotics in preterm labor (PTL) with intact membranes, after evaluating intra-amniotic microbes by our rapid and bacteria-free polymerase chain reaction (PCR) system.
  
  
  METHODS
  One hundred and four PTL patients before 32 weeks of gestation were recruited. Until 2012, antibiotics were empirically prescribed based on the clinical severity of PTL. Intra-amniotic microbes in stored samples were evaluated later by our newly established PCR system, and the efficacy of the use of antibiotics in PTL was evaluated.
  
  
  RESULTS
  In the amniotic fluid (AF) microbe-negative patients (n = 67), antibiotic therapy significantly shortened the gestation period (P < 0.0001), whereas in the microbe-positive patients (n = 37), appropriate antibiotic therapy (proper antibiotic selection against identified AF microbes) was significantly associated with an increase in gestation period (P < 0.0001).
  
  
  CONCLUSIONS
  Appropriate antibiotic therapy in PTL with intact membranes prolonged the gestation period.
authors.affiliation: Department of Obstetrics and Gynecology, University of Toyama, Toyama, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yoneda
authors.affiliation: Department of Obstetrics and Gynecology, University of Toyama, Toyama, Japan.
authors.forename: Arihiro
authors.initials: A
authors.lastname: Shiozaki
authors.affiliation: Department of Obstetrics and Gynecology, University of Toyama, Toyama, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Yoneda
authors.affiliation: Department of Obstetrics and Gynecology, University of Toyama, Toyama, Japan.
authors.forename: Mika
authors.initials: M
authors.lastname: Ito
authors.affiliation: Department of Obstetrics and Gynecology, University of Toyama, Toyama, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Shima
authors.affiliation: Department of Obstetrics and Gynecology, University of Toyama, Toyama, Japan.
authors.forename: Kaori
authors.initials: K
authors.lastname: Fukuda
authors.affiliation: Clinical Laboratory Center, University of Toyama, Toyama, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Ueno
authors.affiliation: Clinical Laboratory Center, University of Toyama, Toyama, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Niimi
authors.affiliation: Clinical Laboratory Center, University of Toyama, Toyama, Japan.
authors.forename: Isao
authors.initials: I
authors.lastname: Kitajima
authors.affiliation: Department of Public Health Faculty of Medicine, University of Toyama, Toyama, Japan.
authors.forename: Mika
authors.initials: M
authors.lastname: Kigawa
authors.affiliation: Department of Obstetrics and Gynecology, University of Toyama, Toyama, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Saito
mesh_terms: D000328:Adult; D000653:Amniotic Fluid / Q000382:microbiology*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001419:Bacteria; D001424:Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D006801:Humans; D016133:Polymerase Chain Reaction / Q000379:methods*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000382:microbiology; D011263:Pregnancy Trimester, Third; D047928:Premature Birth / Q000139:chemically induced / Q000175:diagnosis / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents
keywords: Amniotic fluid; PCR; antibiotic therapy; microbes; preterm labor