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Preterm prelabour rupture of membranes (pPROM) is a common cause of infectious morbidity in the mother and the neonate. The recently updated review includes 19 trials (out of 33 identified articles) with more than 6000 women overall. Giving antibiotics to women with pPROM is associated with a statistically significant reduction in chorioamnionitis (Relative risk [RR]: 0.57, 95% confidence interval [CI] 0.37 0.86). There was also a statistically significant reduction in deliveries within 48 hours (RR 0.71, 95% CI 0.58 0.87) and 7 days of randomization (RR 0.80, 95% CI 0.71 0.90).

The following markers of neonatal morbidity were also reduced: neonatal infection (including pneumonia) (RR 0.68, 95% CI 0.53 0.87), use of surfactant (RR 0.83, 95% CI 0.72 0.96), the numbers of babies requiring oxygen therapy overall (RR 0.88, 95% CI 0.81 0.96) and the number of babies diagnosed with abnormal cerebral ultrasound (RR 0.82, 95% CI 0.68 0.98). There was a significant increase in cases of babies with necrotizing enterocolitis (two trials, RR 4.60, 95% CI 1.98 10.72) in babies who received co-amoxyclav or augmentin as antibiotics.

The conclusion of the review is that antibiotic administration following pPROM is associated with a delay in delivery and a reduction in markers of serious neonatal morbidity with the exception of necrotizing enterocolitis.

All adequately controlled trials, which could be identified, have been included and appropriately analysed. There were some articles which were excluded in the previous version of this review which were now included, despite being available at the previous time. This led to some changes in the values of the relative risks, although the conclusions remained practically the same.

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