Comparison of Azithromycin and Erythromycin Effects in Reducing Preterm Premature Rupture of Membranes Outcomes: A Clinical Trial Study

Preterm premature rupture of membranes (PPROM) is one of the important causes of perinatal mortality. This study aimed to compare the effects of azithromycin and erythromycin on pregnancy outcomes in mothers with PPROM.

In this clinical trial study, patients diagnosed with PPROM between 24 and 34 weeks were treated with two drug regimens. Group A (n = 30) received oral azithromycin one-gram single dose and Group B (n = 30) received oral erythromycin 400 mg every 6 hr for 7 days. In addition, both groups were treated with intravenous ampicillin 2 grams every 6 hours for 48 hours and then amoxicillin 250 mg orally every 8 hours for 5 days. Primary outcomes including latency period and clinical chorioamnionitis and secondary outcomes including the type of delivery, amniotic fluid stained with meconium, postpartum endometritis, neonatal sepsis, baby's birth weight, and live birth rate were compared between the two groups.

In the current study, the latency period was significantly higher, while postpartum endometritis and laboratory-confirmed neonatal sepsis were significantly lower in the azithromycin group than in the erythromycin group. Other outcomes did not show significant differences between the two groups.

Azithromycin is more effective than erythromycin in the increased latency periods and decreased postpartum endometritis and neonatal sepsis in women with PPROM. Therefore, azithromycin can be a suitable alternative to erythromycin in the treatment of PPROM.