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Abstract Title of the study: Azithromycin versus Erythromycin in Preterm Premature Rupture of Membranes: Mansoura Experience. summary : Introduction: Preterm premature rupture of membranes (PPROM) is defined as rupture of fetal membranes before onset of labour at less than 37 completed weeks of gestation. The rationale for antibiotic prophylaxis is that infection appears to be both a cause and consequence of PPROM. Erythromycin is the recommended antibiotic in the regimen of management of PPROM, prevention of chorioamnionitis and increasing pregnancy latency. Aim of study: This study aimed to assess the effectiveness, side effects, and cost of azithromycin versus erythromycin in management of PPROM. Patient and methods: All the included females were randomly distributed into two groups; group A that included 135 cases, who received Azithromycin 500mg orally every 12 hours for 5 days and group B that included 134 cases who received Erythromycin 500mg orally every 8 hours for 5 days. After treatment the cases were followed up to determine the outcomes including primary outcome (the duration of latency) and secondary outcomes (chorioamnionitis, neonatal death, neonatal respiratory distress, cost of drugs and side effects). Results: There was no statistically significant difference between studied groups as regards age of the cases, gestational age, body mass index, parity and number of CS. There was no statistically significant difference between groups detected for CRP, total leucocytic count, AFI & foetal heart rate. There was no statistically significant difference between the two study groups regarding latency, mode of delivery, chorioamnionitis and maternal sepsis. There was no statistically significant difference detected between studied groups as regards gestational age, birth weight, APGAR score, respiratory distress, neonatal sepsis & death. There was a statistically significant difference between studied groups as regards incidence of nausea, vomiting and diarrhea. Higher incidence of these side effects were detected among erythromycin than Azithromycin group. conclusion: Azithromycin could be considered as an alternative to erythromycin in the management of preterm premature rupture of membranes if erythromycin is unavailable or contraindicated. There appears to be no additional benefit to azithromycin except for the availability and the less gastrointestinal side effects. |