What is the duration of antibiotic regimens in the management of premature rupture of membranes (PROM)?

Updated: Oct 05, 2018
  • Author: Allahyar Jazayeri, MD, PhD, FACOG, DACOG, FSMFM; Chief Editor: Carl V Smith, MD  more...
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Based on current evidence, 7 days of antibiotics, as proposed by the NICHD-MFMU study of PROM, should be the antibiotic regimen used in patients with PPROM who are being managed expectantly. When another antibiotic is being used for other indications, such as a urinary tract infection, attempts should be made to avoid duplicated therapy. For example, a patient being treated with a cephalosporin for a urinary tract infection does not need penicillin therapy. Therapy longer than 7 days should be avoided; it has not been shown to be more effective and may promote the emergence of resistance organisms.

Revised guidelines from the Centers for Disease Control and Prevention (CDC) recommend that women with preterm PROM who are not in labor should receive intravenous group B streptococcus (GBS) coverage for at least the first 48 hours of preterm PROM latency prophylaxis, until the GBS test results obtained on admission are available. [20] However, GBS test results should not affect the duration of antibiotic therapy. If the patient completes the full 7-day course of antibiotic prophylaxis has no evidence of infection or labor, intrapartum GBS prophylaxis can be managed based on the results of the baseline GBS test at the time of preterm PROM, unless 5 weeks have passed. This is because a negative GBS test result is considered valid for 5 weeks. [21, 22]

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