# Comparison of Seven-Day Versus Continuous Prophylactic Antibiotic Therapy Until Delivery in Preterm Premature Rupture of Membranes

## TL;DR

This study compares seven-day versus continuous antibiotic use in preterm premature rupture of membranes, finding similar effectiveness with shorter neonatal hospital stays.

## Contribution

The study introduces evidence that seven-day antibiotic therapy is non-inferior to continuous use in PPROM cases.

## Key findings

- Seven-day antibiotic therapy reduced persistent amniotic fluid leakage compared to continuous therapy.
- Neonates in the seven-day group had shorter hospital stays and fewer required high-flow nasal cannula support.
- Both groups showed similar need for CPAP support in neonates.

## Abstract

Background and aim

Preterm prelabour rupture of membranes (PPROM) refers to the spontaneous rupture of fetal membranes before the onset of labor and prior to 37 completed weeks of gestation. PPROM is associated with significant maternal and neonatal complications. Maternal risks include chorioamnionitis, abruptio placentae, and postpartum infections. Neonatal complications commonly observed are respiratory distress syndrome (RDS), neonatal sepsis, cerebral palsy, and necrotizing enterocolitis (NEC). This study aimed to evaluate and compare maternal and neonatal outcomes in women with PPROM treated with prophylactic antibiotics for seven days versus antibiotics administered until delivery.

Materials and methods

This comparative study included 110 pregnant women between 26 weeks 0 days and 36 weeks six days of gestation. Participants were divided into the following two groups: group 1 received prophylactic antibiotics for seven days, and group 2 received antibiotics until delivery. Data collected included the duration of membrane rupture, types of antibiotics used, and various maternal and neonatal outcomes.

Results

A significantly lower incidence of persistent amniotic fluid leakage was observed in group 1 (31; 56.4%) compared to group 2 (45; 81.8%) (p<0.002). Continuous positive airway pressure (CPAP) support was not required in 41 (74.5%) of neonates in group 1 and 40 (72.7%) in group 2. However, a significantly higher proportion of neonates in group 2 required high-flow nasal cannula (HFNC) support compared to group 1 (p=0.015). Additionally, a shorter neonatal hospital stay (one to three days) was more frequent in group 1 (29; 52.7%) than in group 2 (17; 30.9%) (p=0.048).

Conclusion

A seven-day course of prophylactic antibiotics in PPROM is as effective as continuous antibiotic therapy until delivery, with added benefits of reduced neonatal hospital stay and potentially fewer antibiotic-associated risks.