[A clinical study on chemotherapies for chorioamnionitis]

Area of Science:

• Obstetrics and Gynecology
• Infectious Diseases
• Pharmacology

Background:

• Chorioamnionitis is a serious complication of pregnancy.
• Effective initial antibiotic therapy is crucial for managing chorioamnionitis.
• Assessing various antibiotic regimens is essential for optimizing patient outcomes.

Purpose of the Study:

• To evaluate the clinical efficacy of imipenem/cilastatin (IPM/CS), flomoxef (FMOX), and combined ceftazidime + aspoxicillin (CAZ/ASPC) as initial therapies for chorioamnionitis.
• To compare the rates of premature labor and bacterial elimination among different treatment groups.
• To determine the optimal antibiotic strategy for chorioamnionitis, considering bacterial spectrum and drug properties.

Main Methods:

• A clinical assessment of 49 women with threatened abortion and 29 with premature rupture of membranes (PROM) complicated by chorioamnionitis.
• Patients received initial therapy with IPM/CS, FMOX, or CAZ/ASPC.
• Clinical response rates, premature labor incidence, latent period prolongation in PROM, and bacterial elimination rates were analyzed.

Main Results:

• A high overall response rate (95.9%) was observed in the threatened abortion group.
• IPM/CS therapy showed a trend towards preventing premature labor more effectively than other regimens.
• The latent period in the PROM group was significantly prolonged (55.5%) compared to previous penicillin therapy.
• Bacterial elimination rate was 50.9%, with a high bacteriological efficacy rate (89.7%) for effective agents, particularly against Gram-positive bacteria.

Conclusions:

• Antibacterial agents effective against Gram-positive bacteria are recommended for chorioamnionitis treatment.
• IPM/CS therapy is a valuable option due to its favorable amniotic fluid transfer and broad antibacterial spectrum.
• Further research may explore IPM/CS as a preferred initial therapy for chorioamnionitis.