• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home The Classics General Medicine Classics

The ORACLE trial: Antibiotics for preterm, prelabor rupture of membranes [Classics Series]

byLeah Hawkins Bressler, MD, MPH
April 18, 2016
in General Medicine Classics, Obstetrics, Obstetrics and Gynecology Classics, The Classics
Reading Time: 2 mins read
0
Share on FacebookShare on Twitter

1. Among infants born to women with preterm, premature rupture of membranes, those whose mothers were randomized to treatment with erythromycin experienced a lower incidence of adverse neonatal outcomes and prolongation of pregnancy compared to the placebo group.

Original Date of Publication: March 2001

Study Rundown: Preterm, premature (prelabor) rupture of membranes (PPROM) is a common cause of preterm birth. Following PPROM, approximately 50% of women will deliver within one week. As such, the majority of infants born to women with PPROM are exposed to risks associated with prematurity including respiratory distress syndrome, necrotizing enterocolitis, intraventricular hemorrhage and retinopathy of prematurity as well as risks of cerebral palsy, blindness and deafness. Further, leakage of amniotic fluid in PPROM can expose the fetus to oligohydramnios and associated Potter sequence complications such as pulmonary hypoplasia, pneumothorax, and skeletal deformities. Lastly, because PPROM involves a breech in the integrity of the amniotic membrane, fetuses exposed to PPROM are at increased risk of complications associated with intrauterine infection, including chorioamnionitis, neonatal sepsis and hypoxemic ischemic encephalopathy. Previous research has demonstrated that subclinical chorioamnionitis plays a role in degrading the amniotic membrane such that most experts agree that the etiology of PPROM is infectious. Researchers theorized that administering antibiotics to women who experience PPROM would improve neonatal health and well-being. As of the late 1990s, trials of antibiotics in PPROM demonstrated an association with prolongation of pregnancy but did not identify reduced risks of common neonatal adverse events. In this large randomized controlled trial, researchers investigated the impact of three different antibiotic regimens: erythromycin, amoxicillin-clavulanic acid or both compared to placebo on neonatal outcomes in infants born to women with PPROM.

This landmark study was the first to demonstrate neonatal benefit to maternal antibiotic use following preterm premature rupture of membranes. In contrast to existing literature, this study employed a large sample size and four treatment arms to distinguish the impact of various treatments compared with placebo. Additional strengths included multicenter randomized trial at more than 150 sites and strict exclusion criteria. The study was conducted in the United Kingdom and results may not apply to populations with differing demographic compositions.

Click to read the study in the Lancet

 

In-Depth [randomized controlled trial]: A total of 4826 women with PPROM were randomized to receive erythromycin (n=1197), amoxicillin-clavulanic acid (n=1212), both (n=1192) or placebo (n=1225) 4 times daily for 10 days or until delivery, whichever came first. Intention-to-treat analysis was applied to evaluate the composite outcome of neonatal death, chronic lung disease or major cerebral abnormality between treatment groups.

RELATED REPORTS

Fetoscopic endoluminal tracheal occlusion improves infant survival for congenital diaphragmatic hernia

Among singleton infants born to women with PPROM randomized to erythromycin or placebo, fewer infants experienced the composite primary outcome of severe adverse neonatal events in the erythromycin group (11.2% vs 14.4%, p=0.02). Erythromycin use was also associated with prolongation of pregnancy and reduction in need for surfactant. Use of both antibiotic regimens containing amoxicillin-clavulanic acid was associated with a higher incidence of neonatal necrotizing enterocolitis (p= 0.0005).

Image: PD

©2015 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: erythromycinpreterm premature rupture of membranes (PPROM)
Previous Post

The PROSEVA trial: Proning in severe ARDS [Classics Series]

Next Post

Gender-associated sexual behavior linked to oral oncogenic HPV rates

RelatedReports

Digital imaging detects sight-threatening retinopathy of prematurity
Obstetrics

Fetoscopic endoluminal tracheal occlusion improves infant survival for congenital diaphragmatic hernia

June 24, 2021
Next Post
Reduced HPV vaccine doses may be adequate

Gender-associated sexual behavior linked to oral oncogenic HPV rates

Non-invasive prenatal testing linked to decreased diagnostic testing

Non-invasive prenatal testing linked to decreased diagnostic testing

Forearm parathyroid reimplantation may be effective in preventing hypoparathyroidism

Forearm parathyroid reimplantation may be effective in preventing hypoparathyroidism

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

Get 2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • University students perceive that Instagram improves social connection but impairs mental wellbeing
  • 2 Minute Medicine Rewind May 22nd, 2022
  • #VisualAbstract: Severe actinic keratosis and need for additional treatment are markers for an increased risk of cutaneous squamous cell carcinoma
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.