Effect of antibiotic regimen on intraamnioticinflammation in premature rupture of membranes andneonatal outcomes

The aim of this study was to evaluate the effect of two different antibiotic regimens on maternal and neonatal clinical outcomes in patients diagnosed with premature rupture of membranes (PROM) between 24-34 weeks. Method: In this prospective randomized controlled study, 100 patients who were initiated antibiotics with the diagnosis of PROM between January 1, 2023 and July 31, 2023 at Van Yüzüncü Yıl University Dursun Odabaşı Medical Center, Department of Obstetrics and Gynecology, Obstetrics Clinic were included. The groups were divided into two groups of 50 patients each according to the antibiotic treatment. (i) Sulbactam + ampicillin 4*2 g in the first 48 hours, 1 g azithromycin on day 3, amoxicillin 500 mg tb 3*1 on days 4-7. (ii) Ceftriaxone 1*1 g + clarithromycin 500 mg 2*1 in the first 48 hours, clarithromycin 500 mg 2*1 + amoxicillin 500 mg 3*1 from day 3. Results: The mean age of the patients was 28.00 ± 4.56 years and the mean gestational age was 30.18 ± 2.82 weeks. The mean latent period was 4.09 ± 2.03 weeks. NICU was needed in 43% of the neonates, respiratory support was needed in 41% and neonatal sepsis developed in 4%. No sepsis or additional pathology was detected in mothers in the postopartum period. The AFI value recorded before delivery was statistically significantly lower in group 2 compared with group 1 (p = 0.012). There was no statistically significant difference between the groups in terms of latent period and other neonatal and maternal clinical outcomes (p>0.05). Conclusion: It was observed that the antibiotic regimens applied in our study were not superior to each other. We think that whichever of these antibiotic regimens is available can be used in PROM cases. In this respect, the effect of antibiotic administration in PROM cases on pregnancy outcomes can be revealed more clearly with more comprehensive studies.