Antibiotic Prophylaxis for Group B Streptococcal Infection in Preterm Premature Rupture of Membranes
Author Information
Author(s): Wayne B. Kramer, George R. Saade, Michael Belfort, Joanne Samora-Mata, Tony Wen, Kenneth J. Moise, Jr.
Primary Institution: Baylor College of Medicine
Hypothesis
Does ampicillin prophylaxis for presumptive group B streptococcal colonization increase neonatal and maternal infectious morbidity compared to no prophylaxis?
Conclusion
Ampicillin prophylaxis increases the risk of postpartum endomyometritis without reducing neonatal sepsis rates.
Supporting Evidence
- 62% of patients receiving ampicillin developed postpartum endomyometritis compared to 22% who did not.
- There was no significant difference in neonatal sepsis rates between the two groups.
- Postpartum endomyometritis occurred in 50% of patients receiving antibiotic prophylaxis.
Takeaway
Giving antibiotics to pregnant women with early water breaking can lead to more infections after birth, even if it doesn't help the baby.
Methodology
Retrospective review of charts from patients with preterm PROM who delivered between January 1988 and December 1993, comparing those who received ampicillin prophylaxis to those who did not.
Potential Biases
Potential bias in patient selection and treatment assignment.
Limitations
The study is retrospective and may be subject to biases in chart review.
Participant Demographics
Patients with preterm PROM, primarily singleton gestations.
Statistical Information
P-Value
P < 0.01 for postpartum endomyometritis incidence.
Statistical Significance
p<0.05
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