Title
Erytromycine bij prematuur gebroken vliezen gunstig voor de gezondheid van het kind [Erythromycin for premature rupture of membranes is beneficial for infant]
Author
Buitendijk, S.E.
Publication year
2001
Abstract
In the 'Overview of the role of antibiotics in curtailing labour and early delivery'(ORACLE I)-trial in women with premature rupture of membranes, the use of erythromycin was found to be associated with a decrease in the primary composite outcome (neonatal death, chronic lung disease or major cerebral abnormality on ultrasound; p = 0.08) and in single adverse neonatal outcomes (p = 0.02) when compared to placebo. The positive results were more significant in the singleton group (p = 0.02 for the composite outcome), while no effects were found in twin pregnancies. The combination of amoxycillin and clavulanic acid, with or without erythromycin, was associated with some improvements in outcome, but was also accompanied by a higher rate of neonatal necrotising enterocolitis. Another trial (ORACLE II) found no effects of antibiotic use in women with premature labour with intact membranes. Although both trials were of good quality, the stratification into singleton and twin pregnancies should have been done more consistently. Because premature rupture of membranes in singleton pregnancies is more likely to be associated with a pre-existing infection than in multiple pregnancies, the potential benefit of treatment with antibiotics is larger in singleton pregnancies. Chemicals/CAS: Amoxicillin-Potassium Clavulanate Combination, 74469-00-4; Anti-Bacterial Agents; Erythromycin, 114-07-8
Subject
Amoxicillin
Clavulanic acid
Placebo
Adult
Antibiotic therapy
Case report
Chronic lung disease
Clinical trial
Echography
Necrotizing enterocolitis
Newborn death
Premature fetus membrane rupture
Premature labor
Review
Amoxicillin-Potassium Clavulanate Combination
Anti-Bacterial Agents
Drug Therapy, Combination
Enterocolitis, Necrotizing
Erythromycin
Female
Fetal Membranes, Premature Rupture
Humans
Infant, Newborn
Obstetric Labor, Premature
Pregnancy
Pregnancy Outcome
Randomized Controlled Trials
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TNO identifier
236228
ISSN
0028-2162
Source
Nederlands Tijdschrift voor Geneeskunde, 145 (38), 1828-1831
Document type
article