A new antibiotic regimen treats and prevents intra-amniotic inflammation/infection in patients with preterm PROM

Joon Ho Lee, Roberto Romero, Sun Min Kim, Piya Chaemsaithong, Bo Hyun Yoon

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Abstract: Objectives: To determine whether 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.

Original languageEnglish
Pages (from-to)2727-2737
Number of pages11
JournalJournal of Maternal-Fetal and Neonatal Medicine
Volume29
Issue number17
DOIs
StatePublished - 1 Sep 2016

Fingerprint

Anti-Bacterial Agents
Inflammation
Infection
Amniocentesis
Clarithromycin
Ceftriaxone
Metronidazole
Cephalosporins
Ampicillin
Matrix Metalloproteinase 8
Amniotic Fluid
Coinfection
Cohort Studies
Retrospective Studies
Therapeutics

Keywords

  • Ceftriaxone
  • chorioamnionitis
  • clarithromycin
  • erythromycin
  • funisitis
  • metronidazole
  • neonatal morbidity
  • neonatal sepsis
  • placental pathology
  • pregnancy
  • prematurity
  • preterm birth
  • preterm labor

Cite this

@article{470c604232194c0aa7500300ab743390,
title = "A new antibiotic regimen treats and prevents intra-amniotic inflammation/infection in patients with preterm PROM",
abstract = "Abstract: Objectives: To determine whether 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.",
keywords = "Ceftriaxone, chorioamnionitis, clarithromycin, erythromycin, funisitis, metronidazole, neonatal morbidity, neonatal sepsis, placental pathology, pregnancy, prematurity, preterm birth, preterm labor",
author = "Lee, {Joon Ho} and Roberto Romero and Kim, {Sun Min} and Piya Chaemsaithong and Yoon, {Bo Hyun}",
year = "2016",
month = "9",
day = "1",
doi = "10.3109/14767058.2015.1103729",
language = "English",
volume = "29",
pages = "2727--2737",
journal = "Journal of Maternal-Fetal and Neonatal Medicine",
issn = "1476-7058",
publisher = "Informa Healthcare",
number = "17",

}

A new antibiotic regimen treats and prevents intra-amniotic inflammation/infection in patients with preterm PROM. / Lee, Joon Ho; Romero, Roberto; Kim, Sun Min; Chaemsaithong, Piya; Yoon, Bo Hyun.

In: Journal of Maternal-Fetal and Neonatal Medicine, Vol. 29, No. 17, 01.09.2016, p. 2727-2737.

Research output: Contribution to journalArticle

TY - JOUR

T1 - A new antibiotic regimen treats and prevents intra-amniotic inflammation/infection in patients with preterm PROM

AU - Lee, Joon Ho

AU - Romero, Roberto

AU - Kim, Sun Min

AU - Chaemsaithong, Piya

AU - Yoon, Bo Hyun

PY - 2016/9/1

Y1 - 2016/9/1

N2 - Abstract: Objectives: To determine whether 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.

AB - Abstract: Objectives: To determine whether 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.

KW - Ceftriaxone

KW - chorioamnionitis

KW - clarithromycin

KW - erythromycin

KW - funisitis

KW - metronidazole

KW - neonatal morbidity

KW - neonatal sepsis

KW - placental pathology

KW - pregnancy

KW - prematurity

KW - preterm birth

KW - preterm labor

UR - http://www.scopus.com/inward/record.url?scp=84949549890&partnerID=8YFLogxK

U2 - 10.3109/14767058.2015.1103729

DO - 10.3109/14767058.2015.1103729

M3 - Article

C2 - 26441216

AN - SCOPUS:84949549890

VL - 29

SP - 2727

EP - 2737

JO - Journal of Maternal-Fetal and Neonatal Medicine

JF - Journal of Maternal-Fetal and Neonatal Medicine

SN - 1476-7058

IS - 17

ER -