Martingano Daniel, Guan Xin, Renson Audrey, Singh Shailini, Kesavan Nasir Meera, Kim Juliette, Carey Jeanne
a Department of Obstetrics and Gynecology , NYU Lutheran Medical Center , Brooklyn , NY , USA.
b Department of Clinical Research and Statistics , NYU Lutheran Medical Center , Brooklyn , NY , USA.
J Matern Fetal Neonatal Med. 2018 May;31(9):1194-1197. doi: 10.1080/14767058.2017.1311861. Epub 2017 Apr 11.
This study aimed to determine whether daily dosing of gentamicin using ideal body weight in the treatment of chorioamnionitis is effective.
We conducted a prospective observational study and followed all women receiving treatment for chorioamnionitis which included gentamicin daily dosing calculated using 5 mg/kg ideal body weight. Patients were excluded if pathological analysis of placenta did not confirm chorioamnionitis. Our primary outcome was resolution of infection following delivery without the development of maternal endometritis and/or neonatal sepsis. Ninety-five percent confidence intervals for proportions were calculated using exact binomial tests. These patients were retrospectively compared to patients who received treatment for chorioamnionitis which included traditional gentamicin every 8 h.
The study included 160 patients. Of the patients receiving daily dosing (n = 80) compared to traditional dosing (n = 80), 96% (95% CI 95.7-97.6%) achieved the primary outcome versus 91% (88.9-93.1%), 2.5% (95% CI 1.2-3.8%) developed endometritis versus 6.3% (4.2-8.4%), 1.3% (95% CI 0.4-2.2%) delivered neonates with sepsis versus 2.5% (1.2-3.8%), and 39% required cesarean delivery (95% CI 46.2-53.8) versus 37% (33.2-40.8%).
Daily dosing of gentamicin using ideal body weight is effective in successful treatment of chorioamnionitis without development endometritis and/or neonatal sepsis across different ethnicities.
本研究旨在确定在治疗绒毛膜羊膜炎时，使用理想体重每日给予庆大霉素是否有效。
我们进行了一项前瞻性观察性研究，对所有接受绒毛膜羊膜炎治疗的女性进行随访，其中包括使用5mg/kg理想体重每日给予庆大霉素。如果胎盘的病理分析未证实绒毛膜羊膜炎，则将患者排除。我们的主要结局是分娩后感染得到解决，且未发生母体子宫内膜炎和/或新生儿败血症。使用精确二项式检验计算比例的95%置信区间。将这些患者与接受绒毛膜羊膜炎治疗（包括每8小时给予传统庆大霉素）的患者进行回顾性比较。
该研究纳入了160例患者。与传统给药组（n = 80）相比，每日给药组（n = 80）中，96%（95%CI 95.7 - 97.6%）达到主要结局，而传统给药组为91%（88.9 - 93.1%）；2.5%（95%CI 1.2 - 3.8%）发生子宫内膜炎，而传统给药组为6.3%（4.2 - 8.4%）；1.3%（95%CI 0.4 - 2.2%）分娩的新生儿患有败血症，而传统给药组为2.5%（1.2 - 3.8%）；39%需要剖宫产（95%CI �6.2 - 53.8），而传统给药组为37%（33.2 - 40.8%）。
使用理想体重每日给予庆大霉素在成功治疗绒毛膜羊膜炎方面是有效的，且在不同种族中均未发生子宫内膜炎和/或新生儿败血症。
