A Randomized Study of Antibiotic Therapy in Idiopathic Preterm Labor
A Randomized Study of Antibiotic Therapy in Idiopathic Preterm Labor
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特发性早产抗生素治疗的随机研究
DOI：
10.1097/00006250-198812000-00002
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发表时间：
1988
影响因子：
7.2
通讯作者：
R. Knuppel
中科院分区：
文献类型：
--
作者：
W. Morales;J. Angel;W. F. O'brien;R. Knuppel
&NA;进行了一项随机研究，以测试抗生素作为已建立的安胎方法的辅助治疗的效果。150例宫颈扩张1 cm或更大且临床上没有可识别的早产原因的患者符合研究条件。53例（35%）患者每6小时口服500 mg氨苄青霉素，50例（33%）患者每6小时口服500 mg红霉素，47例作为对照。抗生素处方10天，治疗没有改变宫颈培养的结果。在这150例患者中，16例（11%）羊水培养阳性。羊水培养阳性的孕妇的特点是入院后获得的时间（2.6对28.7天）和出生体重（1262对2470 g）明显少于羊水培养阴性的孕妇。134例羊水培养阴性的患者中，胎盘组织学检查显示22例（16%）有绒毛膜炎;与无组织学绒毛膜炎的妊娠相比，这些妊娠与入院后增加的时间更短（12.5天vs 31.9天）和出生体重更低（1680 g vs 2618 g）相关。在胎龄和宫颈扩张相似的患者中，连续使用抗生素治疗导致从入院到分娩的统计学显著延迟（30天对17天）。在羊水培养阴性的病例中，宫颈定植B组链球菌和/或阴道加德纳菌增加早产的风险，给予氨苄青霉素后，早产风险显著改善。
&NA; A randomized study was undertaken to test the effects of antibiotics as an adjunct to established methods of tocolysis. One hundred fifty patients with cervical dilation of 1 cm or more and no clinically identifiable cause for preterm labor qualified for the study. Fifty‐three (35%) received 500 mg ampicillin orally every 6 hours, 50 (33%) received 500 mg erythromycin orally every 6 hours, and 47 served as controls. Antibiotics were prescribed for 10 days, and the treatment was not altered by the results of cervical cultures. Of these 150 patients, 16 (11%) had positive amniotic fluid cultures. The pregnancies with positive amniotic fluid culture were characterized by significantly less time gained after admission (2.6 versus 28.7 days) and lower birth weight (1262 versus 2470 g) than in those with negative cultures. Histologic studies of the placenta revealed chorioamnionitis in 22 (16%) of 134 patients with negative amniotic fluid cultures; these pregnancies were associated with less time gained after admission (12.5 versus 31.9 days) and lower birth weight (1680 versus 2618 g) compared with pregnancies without histologic chorioamnionitis. In patients with similar gestational age and cervical dilation, the adjunctive use of antibiotic therapy resulted in a statistically significant delay from admission to delivery (30 versus 17 days). In cases of negative amniotic fluid cultures, cervical colonization with group B streptococcus and/or Gardnerella vaginalis increased the risk of prematurity, which improved significantly when ampicillin was given.