ArticleDrug design, development and therapy2026
Evaluation of Preventive Antibiotic Regimens for Preterm Premature Rupture of Membranes: Efficacy and Safety of Triple Therapy versus Cephalosporin Monotherapy.
Article in Drug design, development and therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: Controversy remains regarding the optimal prophylactic antibiotic regimen for preterm premature rupture of membranes (PPROM). This study compared the efficacy and benefits of cephalosporin monotherapy with a triple-therapy regimen comprising a cephalosporin, azithromycin, and clindamycin. Patients and Methods: We conducted a single-center cohort study at a tertiary hospital in China from January 2024 to June 2025, prospectively enrolling pregnant women receiving triple therapy and retrospectively selecting those receiving cephalosporin monotherapy as controls. Maternal analyses included 32 patients in the triple-therapy group and 60 in the monotherapy group; neonatal analyses included 36 and 65 infants, respectively (twins analyzed separately). Inverse probability of treatment weighting was used to adjust for baseline confounding, propensity score matching and multiple regression were applied for sensitivity analysis. And subgroup analysis was stratified by gestational age. Results: After adjusting, no significant between-group differences were observed in the primary maternal composite outcome (P=0.510) or neonatal respiratory distress syndrome (P=0.227). In exploratory secondary analyses, triple therapy was associated with lower observed risks of bronchopulmonary dysplasia(BPD) (P=0.010) and intraventricular hemorrhage(IVH) (P<0.001). In the 24-34-week gestation subgroup, it also prolonged gestational age versus the monotherapy regimen. No other secondary outcomes differed significantly. The conclusions of sensitivity analyses were basically consistent with the main analysis. Conclusion: Triple therapy was not associated with significant differences in the primary maternal or neonatal outcomes compared with cephalosporin monotherapy. Exploratory findings suggested possible associations with a longer latency interval among women with PPROM at 24 - 34 - week of gestation subgroup and with lower observed risks of BPD and IVH. Given the limited sample size, small numbers of events, and nonrandomized design, these findings should be interpreted cautiously and confirmed in larger prospective studies.
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