Comment on “Ampicillin and Gentamicin Prophylaxis Is Superior to Ampicillin Alone in Patients With Prelabor Rupture of Membranes at Term: The Results of a Randomized Clinical Trial”
Randomized clinical trial compares ampicillin with gentamicin versus ampicillin alone, revealing improved maternal and neonatal outcomes.
Key Points
This research aims to compare the effectiveness of ampicillin combined with gentamicin against ampicillin alone in managing complications arising from prelabor rupture of membranes (PROM).
Conducted as an open-label randomized clinical trial at a university-affiliated hospital.
Included patients aged 18 and older with term singleton pregnancies experiencing PROM for 12 to 18 hours.
Participants were randomized to receive either ampicillin with gentamicin or ampicillin alone.
Primary and secondary outcomes were defined to assess maternal and neonatal health post-treatment.
The ampicillin with gentamicin group showed significantly lower rates of clinical chorioamnionitis at 1.0% versus 7.8% in the ampicillin-alone group (P = 0.035).
Lower rates of total peripartum infections observed in the gentamicin group (1.0% vs 9.8%, P = 0.005).
The ampicillin with gentamicin group had significantly fewer cases of infection-related hospitalization (0% vs 5.9%, P = 0.029).
Neonatal adverse outcomes were notably lower in the gentamicin group, also showing a reduction in positive Enterobacteriaceae cultures.