Amer J Perinatol 2017; 34(11): 1102-1107
DOI: 10.1055/s-0037-1603915
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Comparison of Azithromycin versus Erythromycin for Prolongation of Latency in Pregnancies Complicated by Preterm Premature Rupture of Membranes

Matthew M. Finneran1, 2, Ashley Appiagyei1, 3, Megan Templin4, Heather Mertz1
  • 1Department of Obstetrics and Gynecology, Carolinas Medical Center, Charlotte, North Carolina
  • 2Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio
  • 3University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
  • 4Center for Outcomes Research and Evaluation, Carolinas Healthcare System, Charlotte, North Carolina
Further Information

Publication History

11 May 2017

15 May 2017

Publication Date:
21 June 2017 (eFirst)

Abstract

Objective To assess the impact on the duration of latency to delivery when a single oral dose of azithromycin is substituted for erythromycin in the standard antibiotic regimen used in pregnancies complicated by preterm premature rupture of membranes (PPROM).

Study Design A retrospective cohort study of singleton pregnancies complicated by PPROM between 23 and 33 6/7 weeks of gestation from January 2012 to June 2016. Patients prior to June 2014 received a standard antibiotic regimen of 7 days of erythromycin and ampicillin/amoxicillin. After this period, patients received a single oral dose of azithromycin 1 g substituted for erythromycin in this regimen. Primary outcome was latency from PPROM to delivery.

Results One hundred sixty-two women met the inclusion criteria, 84 in the erythromycin group and 78 in the azithromycin group. There was no difference in the median latency from PPROM to delivery between the groups (erythromycin: 6.37 days, interquartile range [IQR]: 3.59–10.93 vs. azithromycin: 5.86 days, IQR: 3.12–12.05, p = 0.75). There was a higher rate of cesarean delivery (48.8 vs. 29.5%, p = 0.01) and positive neonatal blood cultures (13.6 vs. 4.1%, p = 0.05) in the erythromycin group.

Conclusion There is no difference in latency to delivery when a single oral dose of azithromycin 1 g is substituted for erythromycin in the standard antibiotic regimen used in singleton pregnancies complicated by PPROM.

Condensation

Substitution of a single oral dose of azithromycin for erythromycin in pregnancies complicated by preterm premature rupture of membranes does not affect latency to delivery.


Note

This research was previously presented as a poster presentation at The Society for Maternal Fetal Medicine (abstract no. 383) on January 26, 2017 in Las Vegas, NV.