Is azithromycin associated with a reduction in acute placental inflammation in the setting of PPROM?

Abstract

Following a national antibiotic shortage, azithromycin has been substituted for erythromycin in the setting of preterm premature rupture of membranes (PPROM) as adjuvant treatment to enhance gestational latency. While clinical outcomes are not inferior, azithromycin’s longer half-life and better tissue penetration has biological plausibility to be a superior antibiotic choice. Acute placental inflammation in the form of maternal (MIR) or fetal inflammatory response (FIR) has been described as a histological correlate and possible early signal for clinical chorioamnionitis.