172: A retrospective comparison of macrolide antibiotics Roxithromycin Vs Azithromycin for Preterm Premature Rupture of Membranes

Abstract

Prophylactic antibiotics are indicated in Preterm Premature Rupture of Membranes (PROM) to prolong latency and to reduce the risk of both neonatal and maternal infections. Macrolides are usually given with penicillin based on their activity against the major pelvic pathogens. We aimed to compare outcomes between two different macrolides: Roxithromycin which is given twice a day for a week and Azithromycin given as a single dose and therefore more convenient Inclusion criteria were: a singletone pregnancy, 24-34 weeks of gestation, preterm PROM. All were treated with penicillin and macrolides: Roxithromycin between July 2005 and May 2016, and Azithromycin between May 2016 and May 2018 based on local protocol changes during those two periods of time. The primary outcome was the length of latency period, defined as time from first antibiotic dose to 34+0 weeks or spontaneous or indicated delivery prior to 34+0 weeks. Secondary outcomes were rates of chorioamnionitis, mode of delivery, birth weight and Apgar scores Of 207 women who met inclusion criteria, 173 received Penicillin and Roxithromycin and 34 received Penicillin and Azithromycin. Baseline characteristics were the same in the two groups. The latency period was longer in the Azithromycin group in compare with the Roxithromycin group (14.09 days and 7.87 days respectively, p=0.003). There was no difference in the rate of chorioamnionitis, the rate of cesarean delivery, Apgar scores and birth weights between the groups Among women with preterm PROM between 24 and 34 completed weeks, Azithromycin compared to Roxithromycin is related with longer latency period.