Broad-spectrum antibiotics for spontaneous preterm labour: the ORACLE II randomised trial. ORACLE Collaborative Group.

Background: Preterm birth after spontaneous preterm labour is associated with death, neonatal disease, and long-term disability. Previous small trials of antibiotics for spontaneous preterm labour have reported inconclusive results. We did a randomised multicentre trial to resolve this issue.Methods...

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Publicado en:Lancet Vol. 357; no. 9261; pp. 989 - 995
Autores principales: Kenyon SL, Taylor DJ, Tarnow-Mordi W, Kenyon, S L, Taylor, D J, Tarnow-Mordi, W
Formato: clinical trial research tables/charts Journal Article
Publicado: Lancet 3/31/2001
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Broad-spectrum antibiotics for spontaneous preterm labour: the ORACLE II randomised trial. ORACLE Collaborative Group.
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          Kenyon SL
          Taylor DJ
          Tarnow-Mordi W
          Kenyon, S L
          Taylor, D J
          Tarnow-Mordi, W
        affil: Department of Obstetrics and Gynaecology, Leicester Royal Infirmary, UK
      sug:
        subj:
          Fetal Membranes, Premature Rupture Drug Therapy
          Labor, Premature Drug Therapy
          Antibiotics Therapeutic Use
          Erythromycin Therapeutic Use
          Amoxicillin Therapeutic Use
          Antibiotics, Combined Therapeutic Use
          Pregnancy
          Pregnancy Outcomes
          Enterocolitis, Necrotizing Chemically Induced
          Treatment Outcomes
          Clinical Trials
          Placebos
          T-Tests
          Mann-Whitney U Test
          Female
          Funding Source
          Human
          Female
      ab: Background: Preterm birth after spontaneous preterm labour is associated with death, neonatal disease, and long-term disability. Previous small trials of antibiotics for spontaneous preterm labour have reported inconclusive results. We did a randomised multicentre trial to resolve this issue.Methods: 6295 women in spontaneous preterm labour with intact membranes and without evidence of clinical infection were randomly assigned 250 mg erythromycin (n=1611), 325 mg co-amoxiclav (250 mg amoxicillin and 125 mg clavulanic acid; n=1550), both (n=1565), or placebo (n=1569) four times daily for 10 days or until delivery, whichever occurred earlier. The primary outcome measure was a composite of neonatal death, chronic lung disease, or major cerebral abnormality on ultrasonography before discharge from hospital. Analysis was by intention to treat.Findings: None of the trial antibiotics was associated with a lower rate of the composite primary outcome than placebo (erythromycin 90 [5.6%], co-amoxiclav 76 [5.0%], both antibiotics 91 [5.9%], vs placebo 78 [5.0%]). However, antibiotic prescription was associated with a lower occurrence of maternal infection.Interpretation: This trial provides evidence that antibiotics should not be routinely prescribed for women in spontaneous preterm labour without evidence of clinical infection.
      pubtype: Academic Journal
      doctype:
        clinical trial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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