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Article Detail
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Preterm premature rupture of membranes management with erythromycin versus azithromycin
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| Author:
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ALAA IBRAHIM ALI
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| Abstract:
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Background: - One of the important pregnancy complications is the preterm premature rupture of membranes, the prevalence is 2%-3% .some advocated to manage with the azithromycin because it is administered easily and has lesser side effects with a lower cost than the erythromycin.
Objective: The assessment of the latency period between the preterm premature rupture of membranes until delivery of those patients managed medically with azithromycin and erythromycin in different doses.
Study design: It was a retrospective cohort study.
Setting: This study was designed in the yermook hospital from April 2019 to September 2019 for about six months' duration.
Patients and Methods: Collection of pregnant women was done, who diagnosed with preterm premature rupture membrane (PPROM) at gestation between 23 plus 6 days to 33 weeks plus 6 days, then for all patients the demographic parameters collected as well as the maternal risk factors, complication of the preterm birth plus the calculation of the latency period, with other parameters such as the gestational age of delivery, the mode of delivery, clinical chorioamnionites, the weight of baby at birth, the fetal complications, Apgar score at 5 minute, neonatal respiratory distress syndrome, intraventricular hemorrhage, sepsis and, neonatal death. Then we classified the women into four groups; group (1) were on 1000 mg oral azithromycin orally as a single dose, group (2) on 500 mg azithromycin for one day then 250 mg azithromycin orally daily for four days, group (3) were on 500 mg azithromycin intravenously for two days, then put on 500 mg azithromycin orally for five days, last group were on 250 mg erythromycin orally every six hours for two days, then 333 mg erythromycin every eight hours for five days.
Results: The 169 patients were enrolled to our study after diagnosed with PPROM, the gestational ages were greater than 23 weeks, after Classification of patients into four groups, we found that Patients in group (3) were older, less likely to have chronic hypertension, pregestational diabetes than patients in other groups, and the gestational age at membrane rupture was later than other groups, with a p-value <0.001.
There was a significant statistical difference among the groups about latency as the P-value 0.02, four days was the median period from rupture of membrane until the delivery for patients on Azithromycin for 5 days while five days for the rest of the groups. As well as the gestational age at delivery showed a statistically significant difference between the groups as the P-value was 0.001.
Conclusion: There was no significant differences found between the four groups of women treated with azithromycin and erythromycin in different regimens of dosing, in relation to latency period until the delivery, chorioamnionitis incidence, outcome of the neonate, for that Azithromycin can be regarded as an alternative antibiotic instead of erythromycin if contraindicated or if not present, particularly in cases of expectant management of PPROM, as single or multiple doses.
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| Keyword:
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Preterm premature rupture of membrane, Azithromycin antibiotics, erythromycin antibiotic
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| EOI:
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-
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| DOI:
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https://doi.org/10.31838/ijpr/2020.12.01.331
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| Download:
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