Lewis D F, Fontenot M T, Brooks G G, Wise R, Perkins M B, Heymann A R
Department of Obstetrics and Gynecology, Louisana State University School of Medicine, Shreveport, USA.
Obstet Gynecol. 1995 Sep;86(3):392-5. doi: 10.1016/0029-7844(95)00181-P.
To compare ampicillin with and without sulbactam with respect to the effect on the latency period after preterm premature rupture of membranes (PROM).
Patients with PROM at 25-35 weeks' gestation were offered participation in a randomized blinded trial comparing ampicillin-sulbactam with ampicillin. Evaluations for cervical pathogens were performed on admission and patients were followed-up with daily maternal and fetal evaluation. Maternal and neonatal outcomes were analyzed using indicated techniques.
Fifty-three women were studied, with 25 receiving ampicillin-sulbactam and 28 receiving ampicillin. The ampicillin-sulbactam group had a significantly longer latency period (433 +/- 625 versus 143 +/- 165 hours, P = .03) and significantly fewer neonatal complications (five versus 20, P < .001). Although no neonatal infectious complications were observed in sulbactam-treated cases, there were four cases of neonatal sepsis and two of neonatal pneumonia in the ampicillin group. Also, significantly more neonates in the ampicillin group required prolonged oxygen and ventilatory support. There was no significant difference in maternal morbidity.
In our population with preterm PROM, a broad-spectrum antibiotic that provides anaerobic coverage appears to extend latency and decrease neonatal morbidity without increasing adverse maternal outcome.
比较含与不含舒巴坦的氨苄西林对早产胎膜早破（PROM）后潜伏期的影响。
邀请妊娠25 - 35周的PROM患者参与一项随机双盲试验，比较氨苄西林 - 舒巴坦与氨苄西林。入院时对宫颈病原体进行评估，患者接受每日的母婴评估随访。使用指定技术分析母婴结局。
共研究了53名女性，其中25名接受氨苄西林 - 舒巴坦治疗，28名接受氨苄西林治疗。氨苄西林 - 舒巴坦组的潜伏期显著更长（433±625小时对143±165小时，P = 0.03），新生儿并发症显著更少（5例对20例，P < 0.001）。虽然在接受舒巴坦治疗的病例中未观察到新生儿感染并发症，但氨苄西林组有4例新生儿败血症和2例新生儿肺炎。此外，氨苄西林组中需要延长吸氧和通气支持的新生儿明显更多。产妇发病率无显著差异。
在我们的早产PROM人群中，一种提供厌氧菌覆盖的广谱抗生素似乎能延长潜伏期并降低新生儿发病率，而不增加产妇不良结局。
