Use of antibiotics to prevent preterm birth

• Published in: American journal of obstetrics and gynecology 1997-08, Vol.177 (2), p.375-380
• Main Authors: Gibbs, Ronald S., Eschenbach, David A.
• Format: Article
• Language: English
• Subjects: Anti-Bacterial Agents - adverse effects; Anti-Bacterial Agents - therapeutic use; Antibacterial agents; Antibiotics; Antibiotics. Antiinfectious agents. Antiparasitic agents; Bacterial Infections - drug therapy; Biological and medical sciences; Extraembryonic Membranes; Female; Fetal Membranes, Premature Rupture; Humans; Medical sciences; Obstetric Labor, Premature - prevention & control; Pharmacology. Drug treatments; Pregnancy; Pregnancy Complications, Infectious - drug therapy; preterm birth; preterm premature rupture of membranes
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/S0002-9378(97)70201-1

Our purpose is to review recent data and provide a clinical opinion on the use of antibiotics to prevent preterm birth or related maternal-neonatal complications. A literature review and a synthesis of opinion are provided. During prenatal care, standard practices should be applied regarding Neisseria gonorrhoeae, Chlamydia trachomatis, and bacteriuria. In addition, screen for and treat bacterial vaginosis in patients at high risk for preterm birth but do not treat Ureaplasma urealyticum or group B streptococci genital colonization. With preterm labor and intact membranes, standard practices should be applied regarding group B streptococci prophylaxis. Do not give antibiotics routinely to prolong pregnancy, but in patients with bacterial vaginosis and Trichomonas vaginalis specific treatment should be given. With preterm premature rupture of membranes, standard practices should be applied regarding group B streptococci prophylaxis, but additional antibiotics should also be given to prolong pregnancies at 24 to 32 weeks' gestation. Reported adverse effects have been few to date. However, increased diligence is needed for resistant organisms. In selected clinical settings antibiotic therapy is now indicated to prolong pregnancy and prevent maternal-neonatal complications associated with preterm birth. (Am J Obstet Gynecol 1997;177:375-80.)