Antibiotic therapy in preterm premature rupture of membranes

Good quality evidence supports the use of antibiotic therapy in women with preterm PROM for whom expectant management is planned. The best evidence supports the choice of an extended-spectrum agent or combination administered intravenously for 2 days followed by an extended spectrum or combination of oral agents for several more days. Despite the effectiveness of antimicrobial therapy in this setting, the potential risks of systemic antibiotic administration, such as allergic reactions, overgrowth of commensal organisms, and emergence of resistant pathogens, much always be kept in mind. Nevertheless, in the majority of cases, assuming the patient is a good candidate for expectant management, the benefits of antibiotic therapy outweigh the risks.