Comparing the Efficacy of Cefotaxime and Ampicillin on Neonatal Infection after Premature Rupture of Membranes

Document Type : Original Article


1 Associate Professor, Department of Pediatrics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Associate Professor, Department of Obstetrics and Gynecology, Ovulation Dysfunction Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Pediatrician, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.


Introduction: Premature rupture of membranes (PROM) may have serious problems for mother, fetus and baby. Determining antibiotic use is various in mothers with these problems due to common causes of maternal vaginal colonization. The aim of this study was comparing the efficacy of cefotaxime and ampicillin on neonatal infection after premature rupture of membranes.
Methods: This clinical trial was conducted on 200 women with premature rupture of membranes who required to use antibiotics in Ghaem hospital, Mashhad, Iran in 2010-2012. Women were divided randomly into two groups: group A received conventional therapy (ampicillin) and group B received cefotaxime. Status of mothers and her fetus until birth and neonates in neonatal ward or neonatal intensive care unit (NICU) until discharge or death was controlled. White blood cell and platelet count, erythrocytes sedimentation rat (ESR), C-reactive protein (CRP), blood cultures, cytology of cerebral spinal fluid, cerebral spinal fluid culture and mortality rates were compared in neonates of both groups. All statistical analyses were performed using SPSS software version 14.5 and chi-square, t-test and Mann-Whitney tests. P value less than 0.05 was considered significant.
Results: The mean length of PROM until delivery (p=0.78), parity (p=0.46), gestational age (p=0.150), birth weight (0.147) and sex (p=0.431) were homogeneous between two groups. Definite infection (p=0.034), high ESR (p=0.003), CRP positive (p=0.049), require hospitalization (p=0.001) and mortality (p<0.05) was higher in neonates who received ampicillin.
Conclusion: The risk of neonatal infection in mothers with PROM who receive cefotaxime is clearly less than mothers who receive ampicillin. 


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