Broad-spectrum antibiotics for preterm, prelabour rupture of fetal membranes: the ORACLE I randomised trial

@article{Kenyon2001BroadspectrumAF,
  title={Broad-spectrum antibiotics for preterm, prelabour rupture of fetal membranes: the ORACLE I randomised trial},
  author={S. Kenyon and D. Taylor and W. Tarnow-Mordi},
  journal={The Lancet},
  year={2001},
  volume={357},
  pages={979-988}
}
BACKGROUND Preterm, prelabour rupture of the fetal membranes (pPROM) is the commonest antecedent of preterm birth, and can lead to death, neonatal disease, and long-term disability. Previous small trials of antibiotics for pPROM suggested some health benefits for the neonate, but the results were inconclusive. We did a randomised multicentre trial to try to resolve this issue. METHODS 4826 women with pPROM were randomly assigned 250 mg erythromycin (n=1197), 325 mg co-amoxiclav (250 mg… Expand
ORACLE—antibiotics for preterm prelabour rupture of the membranes: short‐term and long‐term outcomes
TLDR
Indications of short‐term respiratory function, chronic lung disease and major neonatal cerebral abnormality were reduced with the prescription of erythromycin, and the use of co‐amoxiclav was associated with a significant increase in the occurrence of neonatal necrotizing enterocolitis. Expand
Broad-spectrum antibiotics for spontaneous preterm labour: the ORACLE II randomised trial
TLDR
Evidence is provided that antibiotics should not be routinely prescribed for women in spontaneous preterm labour without evidence of clinical infection, and antibiotic prescription was associated with a lower occurrence of maternal infection. Expand
Antibiotic therapy for preterm premature rupture of membranes – results of a multicenter study
TLDR
Antibiotic administration following preterm premature rupture of membranes is associated with a prolongation of pregnancy and a reduction of neonatal infectious morbidity. Expand
The Effect of Non-penicillin Antibiotic Regimens on Neonatal Outcomes in Preterm Premature Rupture of Membranes
TLDR
In this cohort, receiving NPCR in the setting of PPROM did not impact the overall risk of adverse neonatal outcomes or latency, but did increase the risk of endometritis. Expand
Antibiotics for preterm premature rupture of membranes.
TLDR
The use of antibiotics following preterm prelabour rupture of membranes (pPROM) is associated with a statistically significant reduction in maternal infection after delivery prior to discharge and there are fewer data relating to specific antibiotics. Expand
Antibiotic therapy for preterm premature rupture of membranes
TLDR
It could be suggested that antibiotics in women with PPROM are mainly beneficial for neonates who have reached a viable gestational age (more than 23 weeks), and potentially before 27 or 30 weeks’ gestation, when the risk of chorioamnionitis is greater. Expand
Antibiotics for Preterm Rupture of the Membranes: A Systematic Review
TLDR
The administration of antibiotics after PROM is associated with a delay in delivery and a reduction in maternal and neonatal morbidity, and these data support the routine use of antibiotics for women with PROM. Expand
Clinical course of preterm prelabor rupture of membranes in the era of prophylactic antibiotics
TLDR
Latency period of PPROM after using prophylactic antibiotics and antenatal corticosteroids increased while neonatal infectious morbidity was low, but maternal infectious morbidities was not increased. Expand
Preterm premature rupture of the membranes at 22 weeks: problem-based approach
TLDR
The aim would be to prolong pregnancy through conservative management to achieve maximum fetal maturity prior to delivery without the onset of chorioamnionitis or neonatal sepsis. Expand
Use of antibiotics for the treatment of preterm parturition and prevention of neonatal morbidity: a metaanalysis.
TLDR
A metaanalysis found that in PTL at a gestation of 34 weeks or less, there is little evidence of benefit from administration of antibiotics, and there was a trend toward reduced culture-positive sepsis in PPROM. Expand
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