24-34 Hafta Arasında Preterm Erken Membran Rüptürü Gelişen Gebelerin Tedavisinde Kullanılan İki Farklı Antibiyotik Rejiminin Neonatal Enflamasyonu ve Erken Neonatal Sepsisi Önlemedeki Etkinliklerinin Karşılaştırılması

Abstract

There is no obvious consensus in the antibiotic usage during management of preterm premature rupture of membranes, based on this situation different antibiotic regimens are recommended. No studies were found showing the efficacy of sulbactam-ampicillin regimen, which is an alternative treatment regimen for intraamniotic infection, in terms of neonatal enflammation and early neonatal sepsis in the treatment of P-EMR compared to the azithromycinampicillin regimen. For this reason, we grouped the newborns and their mothers who were followed up with the diagnosis of Preterm Early Membrane Rupture in the Neonatal Intensive Care Unit of Hacettepe University İhsan Dogramacı Children's Hospital between 2015-2020 and in the Neonatal Intensive Care Unit of Ankara City Hospital between 2019-2021, according to the antibiotics used in the treatment of preterm premature rupture of membranes. We aimed to compare the efficacy of treatments given during the antenatal period in preventing neonatal inflammation and early neonatal sepsis. As a result of the examination of 208 patients included in the study, no difference was found in the frequency of early neonatal sepsis between the patients in the sulbactam-ampicillin (n=100) regimen group and those given the azithromycin-ampicillin (n=108) regimen (p=0.75). Serum procalcitonin level Z score was found to be higher in the group treated with sulbactam-ampicillin (n=92) than in the group treated with azithromycin-ampicillin (n=95) group (p<0.001). Total leukocyte count was found to be higher in the group given sulbactam-ampicillin treatment (n=100) than in the group treated with azithromycin-ampicillin (n=108) group (p=0.042). Serum CRP level Z score was found to be lower in the group given sulbactam-ampicillin treatment (n=97) compared to the group treated with azithromycin-ampicillin (n=102) group (p<0.042). There was no difference between the groups in terms of bronchopulmonary dysplasia (p=0.096), necrotizing enterocolitis (p=0.11), patent ductus arteriosus (p=