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

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

来  源:   DOI:10.1016/j.jgyn.2013.12.005

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.
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.
CONCLUSIONS: 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.
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