Azithromycin better than Erythromycin for treatment of preterm prelabour rupture of membranes: Study

This study aimed to estimate the effect of erythromycin vs azithromycin on the duration of latency and the rate of clinical chorioamnionitis in women with preterm prelabour rupture of membranes by performing a systematic review and meta-analysis of the existing literature.

Studies comparing the duration of latency and the rate of clinical chorioamnionitis between women with preterm prelabour rupture of membranes who were treated with erythromycin and those who were treated with azithromycin at the time of diagnosis were included.

Here, 2 reviewers separately ascertained studies, obtained data, and gauged study quality. The mean length of latency and the rate of clinical chorioamnionitis were compared and mean differences and odds ratios with 95% confidence intervals were estimated.

Results of the study are:

A total of 5 studies with 1289 women were identified. The mean length of latency in women with preterm prelabour rupture of membranes was similar between individuals treated with erythromycin and those treated with azithromycin: 6.6 days vs 6.7 days (mean difference, 0.07 days; 95% confidence interval, −0.45 to 0.60; I2, 0%). The median point prevalence rates of clinical chorioamnionitis were 25% (95% confidence interval, 12–32) in women treated with erythromycin and 14% (95% confidence interval, 9–24) in women treated with azithromycin. The overall clinical chorioamnionitis rate in women treated with azithromycin was lower than women treated with erythromycin (pooled odds ratio, 0.53; 95% confidence interval, 0.39–0.71; I2, 0%).

Thus, the administration of azithromycin in women with preterm prelabour rupture of membranes was associated with a similar latency period but a lower rate of clinical chorioamnionitis than the administration of erythromycin.

Reference:

Erythromycin vs azithromycin for treatment of preterm prelabour rupture of membranes: a systematic review and meta-analysis by Rachel D.Seaman et al. published in the American Journal of Obstetrics and Gynecology.

https://www.sciencedirect.com/science/article/abs/pii/S0002937821029574