Seaman Rachel D, Kopkin Rachel H, Turrentine Mark A
Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX.
Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX.
Am J Obstet Gynecol. 2022 Jun;226(6):794-801.e1. doi: 10.1016/j.ajog.2021.12.262. Epub 2021 Dec 29.
This study aimed to estimate the effect of erythromycin vs azithromycin on the duration of latency and the rate of clinical chorioamnionitis in women with preterm prelabor rupture of membranes by performing a systematic review and meta-analysis of the existing literature.
From inception to October 2021, we explored MEDLINE, Scopus, Embase, CINAHL, ClinicalTrials.gov, and Cochrane Central Register of Controlled Trials.
Studies comparing the duration of latency and the rate of clinical chorioamnionitis between women with preterm prelabor rupture of membranes who were treated with erythromycin and those who were treated with azithromycin at the time of diagnosis were included.
Here, 2 reviewers separately ascertained studies, obtained data, and gauged study quality. The mean length of latency and the rate of clinical chorioamnionitis were compared and mean differences and odds ratios with 95% confidence intervals were estimated.
A total of 5 studies with 1289 women were identified. The mean length of latency in women with preterm prelabor rupture of membranes was similar between individuals treated with erythromycin and those treated with azithromycin: 6.6 days vs 6.7 days (mean difference, 0.07 days; 95% confidence interval, -0.45 to 0.60; I, 0%). The median point prevalence rates of clinical chorioamnionitis were 25% (95% confidence interval, 12-32) in women treated with erythromycin and 14% (95% confidence interval, 9-24) in women treated with azithromycin. The overall clinical chorioamnionitis rate in women treated with azithromycin was lower than women treated with erythromycin (pooled odds ratio, 0.53; 95% confidence interval, 0.39-0.71; I, 0%).
The administration of azithromycin in women with preterm prelabor rupture of membranes was associated with a similar latency period but a lower rate of clinical chorioamnionitis than the administration of erythromycin.
本研究旨在通过对现有文献进行系统评价和荟萃分析，评估红霉素与阿奇霉素对胎膜早破早产女性潜伏期时长及临床绒毛膜羊膜炎发生率的影响。
从数据库创建至2021年10月，我们检索了MEDLINE、Scopus、Embase、CINAHL、ClinicalTrials.gov以及Cochrane对照试验中心注册库。
纳入比较诊断时接受红霉素治疗与接受阿奇霉素治疗的胎膜早破早产女性潜伏期时长及临床绒毛膜羊膜炎发生率的研究。
由2名研究者分别确定研究、获取数据并评估研究质量。比较潜伏期平均时长及临床绒毛膜羊膜炎发生率，并估计平均差及95%置信区间的比值比。
共纳入5项研究，涉及1289名女性。接受红霉素治疗的胎膜早破早产女性与接受阿奇霉素治疗的女性潜伏期平均时长相似：分别为6.6天和6.7天（平均差为0.07天；95%置信区间为-0.45至0.60；I²为0%）。接受红霉素治疗的女性临床绒毛膜羊膜炎的时点患病率中位数为25%（95%置信区间为12 - 32），接受阿奇霉素治疗的女性为14%（95%置信区间为9 - 24）。接受阿奇霉素治疗的女性总体临床绒毛膜羊膜炎发生率低于接受红霉素治疗的女性（合并比值比为0.53；95%置信区间为0.39 - 0.71；I²为0%）。
胎膜早破早产女性使用阿奇霉素治疗与红霉素治疗相比，潜伏期相似，但临床绒毛膜羊膜炎发生率较低。
