Antibiotic regimens for management of intraamniotic infection

It would seem prudent to start antibiotics to women with clinical intra-amniotic infection because the consequences of not doing so are potentially dangerous.

RHL Commentary by Lukman Yusuf

EVIDENCE SUMMARY

Two trials were included in the review. One trial compared an intrapartum regimen of ampicillin plus gentamycin for reducing postpartum infection to the same regimen postpartum (1). Immediate intrapartum treatment seemed to be more effective in reducing neonatal sepsis (relative risk; RR: 0.08, 95% confidential interval CI: 0.00–1.44) and neonatal pneumonia (RR: 0.15, 95% CI: 0.01 to 2.92). The second trial compared a regimen of ampicillin plus gentamycin with ampicillin plus gentamycin plus clindamycin. With both regimens there were similar numbers of newborn complications and fewer cases of postpartum endometritis. However, given that only two trials involving 181 women were eligible for inclusion, the confidence intervals are wide and the evidence base is quite weak.

The review seems to have been conducted satisfactorily.

The full RHL commentary also includes sections on:

Relevance
- Magnitude of the problem
- Applicability of the results
- Implementation of the intervention
Research
References

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This document should be cited as: Lukman Yusuf. Antibiotic regimens for management of intraamniotic infection: RHL commentary (last revised: 31 August 2004). The WHO Reproductive Health Library, No 9, Update Software Ltd, Oxford, 2006. www.rhlibrary.com