Kylie Hae-Jin Chang1, Hyun-Joo Kim1, Hee Joon Yu2, Jeehun Lee3, Jung-Sun Kim4, Suk-Joo Choi1, Soo-Young Oh1, Cheong-Rae Roh1, Jong-Hwa Kim1. 1. a Department of Obstetrics and Gynecology , Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul , Republic of Korea. 2. b Department of Pediatrics , Sacred Heart Hospital, Hallym University College of Medicine , Anyang , Republic of Korea. 3. c Department of Pediatrics , Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul , Republic of Korea , and. 4. d Department of Pathology, Samsung Medical Center , Sungkyunkwan University School of Medicine , Seoul , Republic of Korea.
Abstract
OBJECTIVES: The objective of this study was to compare neonatal morbidity and neurologic outcome at 2 years between groups treated with antibiotics regimens consisting clarithromycin and erythromycin in preterm premature rupture of the membranes (pPROM) patients delivered before 32 weeks of gestation. METHODS: This was a retrospective study comparing neonatal morbidity as primary outcome measures and the neurological outcome at 2 years as secondary outcome. RESULTS: A total of 166 women were included: 80 treated with erythromycin and 86 treated with clarithromycin. The median gestational age at delivery was greater in clarithromycin group (p = 0.005). There was no significant difference in latency (p = 0.77). The incidence of histological chorioamnionitis was significantly lower in clarithromycin group (p = 0.004). By multivariable analysis adjusting confounding variables, the incidence of bronchopulmonary dysplasia and intraventricular hemorrhage (≥Grade 3) was lower in clarithromycin group (BPD; OR 0.34, 95% CI [0.13-0.90]), IVH; OR 0.23, 95% CI [0.06-0.91], respectively). Other morbidities and neurologic outcome at 2 years' corrected age showed no statistically significant difference between two groups. CONCLUSION: We suggest that clarithromycin-based regimen may be worth considering as an alternative choice of erythromycin in pPROM patients.
OBJECTIVES: The objective of this study was to compare neonatal morbidity and neurologic outcome at 2 years between groups treated with antibiotics regimens consisting clarithromycin and erythromycin in preterm premature rupture of the membranes (pPROM) patients delivered before 32 weeks of gestation. METHODS: This was a retrospective study comparing neonatal morbidity as primary outcome measures and the neurological outcome at 2 years as secondary outcome. RESULTS: A total of 166 women were included: 80 treated with erythromycin and 86 treated with clarithromycin. The median gestational age at delivery was greater in clarithromycin group (p = 0.005). There was no significant difference in latency (p = 0.77). The incidence of histological chorioamnionitis was significantly lower in clarithromycin group (p = 0.004). By multivariable analysis adjusting confounding variables, the incidence of bronchopulmonary dysplasia and intraventricular hemorrhage (≥Grade 3) was lower in clarithromycin group (BPD; OR 0.34, 95% CI [0.13-0.90]), IVH; OR 0.23, 95% CI [0.06-0.91], respectively). Other morbidities and neurologic outcome at 2 years' corrected age showed no statistically significant difference between two groups. CONCLUSION: We suggest that clarithromycin-based regimen may be worth considering as an alternative choice of erythromycin in pPROM patients.
Entities:
Keywords:
Bronchopulmonary dysplasia; clarithromycin; erythromycin; intraventricular hemorrhage; preterm premature rupture of the membranes