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Deprecated: Implicit conversion from float 251.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 J+Matern+Fetal+Neonatal+Med 2016 ; 29 (17): 2727-37 Nephropedia Template TP
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A New Antibiotic Regimen Treats and Prevents Intra-Amniotic Infection/Inflammation in Patients with Preterm PROM #MMPMID26441216
Lee J; Romero R; Kim SM; Chaemsaithong P; Yoon BH
J Matern Fetal Neonatal Med 2016[Sep]; 29 (17): 2727-37 PMID26441216show ga
Objective: To determine if a new antibiotic regimen could reduce the frequency of intra-amniotic inflammation/infection in patients with preterm PROM. Study design: This retrospective cohort study was conducted to evaluate the effect of antibiotics on the frequency of intra-amniotic inflammation/infection based on the results of follow-up transabdominal amniocenteses from 89 patients diagnosed with preterm PROM who underwent serial amniocenteses. From 1993?2003, ampicillin and/or cephalosporins or a combination was used (?regimen 1?). A new regimen (ceftriaxone, clarithromycin, and metronidazole) was used from 2003?2012 (?regimen 2?). Amniotic fluid was cultured and matrix metalloproteinase-8 (MMP-8) concentrations were measured. Results: 1) The rates of intra-amniotic inflammation and intra-amniotic inflammation/infection in patients who received regimen 2 decreased during treatment from 68.8% to 52.1% and from 75% to 54.2%, respectively. In contrast, in patients who received regimen 1, the frequency of intra-amniotic inflammation and infection/inflammation increased during treatment (31.7% to 55% and 34.1% to 58.5%, respectively); and 2) intra-amniotic inflammation/infection was eradicated in 33.3% of patients who received regimen 2, but in none who received regimen 1. Conclusion: The administration of ceftriaxone, clarithromycin, and metronidazole was associated with a more successful eradication of intra-amniotic inflammation/infection and prevented secondary intra-amniotic inflammation/infection more frequently than an antibiotic regimen which included ampicillin and/or cephalosporins in patients with preterm PROM.