Newton E R, Dinsmoor M J, Gibbs R S
Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio.
Obstet Gynecol. 1989 Oct;74(4):562-6.
Because subclinical genital tract infection may play a major role in preterm birth, the efficacy of adjunctive antibiotic therapy in combination with standard parenteral tocolysis was examined in a randomized, blinded study of patients with idiopathic preterm labor. Labor was documented by three contractions in 20 minutes, cervical dilation of 1 cm or more, and the need for parenteral tocolysis. Enrollment was restricted to patients with intact membranes and without known causes for preterm labor. One hundred three patients at 24-34 weeks' gestation were randomized to intravenous ampicillin plus oral erythromycin or corresponding placebos. Compared with the placebo group, the adjunctive antibiotic group had a similar frequency of preterm birth (38 versus 44%), time to delivery (34 versus 34 days), birth weight (2847 versus 2855 g), and episodes of recurrent labor requiring parenteral tocolysis (0.43 versus 0.49). In our population, we found no benefit to the adjunctive use of ampicillin plus erythromycin. Significant differences in genital microflora between our patients and those of other studies may explain our results.
由于亚临床生殖道感染可能在早产中起主要作用，因此在一项针对特发性早产患者的随机、盲法研究中，对辅助抗生素治疗联合标准胃肠外tocolysis（抑制宫缩）的疗效进行了研究。通过20分钟内出现三次宫缩、宫颈扩张1厘米或更多以及需要胃肠外tocolysis来记录临产情况。入组仅限于胎膜完整且无已知早产原因的患者。103例妊娠24 - 34周的患者被随机分为静脉注射氨苄青霉素加口服红霉素组或相应的安慰剂组。与安慰剂组相比，辅助抗生素组的早产频率（38%对44%）、分娩时间（34天对34天）、出生体重（2847克对2855克）以及需要胃肠外tocolysis的复发性宫缩发作次数（0.43对0.49）相似。在我们的研究人群中，我们发现使用氨苄青霉素加红霉素进行辅助治疗并无益处。我们的患者与其他研究中的患者在生殖微生物群方面的显著差异可能解释了我们的研究结果。
