[Antibiotic prophylaxis in preterm premature rupture of membranes: CNGOF preterm premature rupture of membranes guidelines]

Gynecol Obstet Fertil Senol. 2018 Dec;46(12):1043-1053. doi: 10.1016/j.gofs.2018.10.017. Epub 2018 Nov 2.
[Article in French]

Abstract

Objective: To analyse benefits and risks of antibiotic prophylaxis in the management of preterm premature rupture of membranes.

Methods: PubMed and Cochrane Central databases search.

Results: Streptoccoccus agalactiae (group B streptococcus) and Escherichia coli are the two main bacteria identified in early neonatal sepsis (EL3). Antibiotic prophylaxis at admission is associated with significant prolongation of pregnancy (EL2), reduction in neonatal morbidity (EL1) without impact on neonatal mortality (EL2). Co-amoxiclav could be associated with an increased risk for neonatal necrotising enterocolitis (EL2). Antibiotic prophylaxis at admission in women with preterm premature rupture of the membranes is recommended (Grade A). Monotherapy with amoxicillin, third generation cephalosporin and erythromycin can be used as well as combination of erythromycin and amoxicillin (Professional consensus) for 7 days (GradeC). Shorter treatment is possible when initial vaginal culture is negative (Professional consensus). Co-amxiclav, aminoglycosides, glycopeptides, first and second generation cephalosporin, clindamycin and metronidazole are not recommended (Professional consensus).

Conclusions: Antibiotic prophylaxis against Streptoccoccus agalactiae (group B streptococcus) and E. coli is recommended in women with preterm premature of the membranes (Grade A). Monotherapy with amoxicillin, third generation cephalosporin or erythromycin, as well as combination of erythromycin and amoxicillin are recommended (Professional consensus).

Keywords: Antibioprophylaxie; Antibiotic prophylaxis; Escherichia coli; Preterm premature rupture of membranes; Rupture prématurée des membranes; Streptococcus agalactiae.

Publication types

  • Practice Guideline

MeSH terms

  • Amoxicillin / administration & dosage
  • Antibiotic Prophylaxis / methods*
  • Cephalosporins / administration & dosage
  • Erythromycin / administration & dosage
  • Escherichia coli
  • Escherichia coli Infections / prevention & control
  • Female
  • Fetal Membranes, Premature Rupture / drug therapy*
  • Fetal Membranes, Premature Rupture / microbiology
  • France
  • Humans
  • Infant, Newborn
  • Neonatal Sepsis / microbiology
  • Neonatal Sepsis / mortality
  • Neonatal Sepsis / prevention & control
  • Pregnancy
  • Premature Birth / prevention & control
  • Streptococcal Infections / prevention & control
  • Streptococcus agalactiae

Substances

  • Cephalosporins
  • Erythromycin
  • Amoxicillin