[A case study regarding the use of antibiotic therapies for the treatment of preterm premature rupture of fetal membranes, and emergence of antibiotic resistant bacteria]

J Gynecol Obstet Biol Reprod (Paris). 2015 Feb;44(2):164-70. doi: 10.1016/j.jgyn.2013.12.005. Epub 2014 May 17.
[Article in French]

Abstract

Objective: The objective of this retrospective study is to compare two types of antimicrobial management used to treat premature rupture of membranes in pregnancy. This study evaluates both duration and the type of antibiotic therapy used for treatment.

Patients and methods: The antimicrobials used to treat premature rupture of membranes include a first generation cephalosporin in one group and amoxicillin in the other group. Cephalosporin was used over a 7-day period to treat 38 cases, whereas amoxicillin was used through delivery in 52 cases. Emergence of multidrug-resistant Gram negative bacteria (GNB) on maternal of neonatal sampling was the primary outcome.

Results: Emergence of antibiotic resistant GNB can be seen under both antibiotic regimens and appears to be linked to the duration of latency, and to duration of antibiotic treatment. Other outcomes (duration of latency period, gestational age at delivery, maternal and neonatal complications) were similar in both groups.

Conclusion: Antibiotic treatment in PPROM favors a selection of GNB. This emergence is positively linked with the duration of latency between rupture of membranes and delivery and with the length of antibiotic administration. The extension of antibiotherapy does not alter other maternal or neonatal parameters.

Keywords: Antibiotherapy; Antibiothérapie; Bacilles Gram négatifs; Gram negative bacilli (GNB); Premature preterm rupture of the membranes (PPROM); Rupture prématurée des membranes avant terme.

Publication types

  • Comparative Study
  • English Abstract
  • Observational Study

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use*
  • Antibiotic Prophylaxis / adverse effects
  • Antibiotic Prophylaxis / statistics & numerical data*
  • Antibiotic Prophylaxis / trends
  • Communicable Diseases, Emerging / epidemiology
  • Drug Resistance, Bacterial*
  • Female
  • Fetal Membranes, Premature Rupture / drug therapy*
  • Fetal Membranes, Premature Rupture / epidemiology
  • Gram-Negative Bacterial Infections / epidemiology
  • Guadeloupe / epidemiology
  • Humans
  • Infant, Newborn
  • Martinique / epidemiology
  • Pregnancy
  • Retrospective Studies

Substances

  • Anti-Bacterial Agents

Supplementary concepts

  • Preterm Premature Rupture of the Membranes