ReviewAntibiotics (Basel, Switzerland)2026
Agent, Dose and Duration: The Unanswered Questions Behind Latency Antibiotic Therapy for Preterm Prelabour Rupture of Membranes.
Review in Antibiotics (Basel, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Latency antibiotic therapy is an established component of expectant management after preterm prelabour rupture of membranes (PPROMs). Pooled randomised evidence from 22 trials involving 6872 women and infants shows that antibiotics prolong pregnancy, reduce chorioamnionitis (risk ratio 0.66) and reduce neonatal infection (risk ratio 0.67), without a significant reduction in perinatal mortality. The evidence supporting the therapeutic principle is stronger than the evidence defining how the therapy should be configured. This narrative review examines the three decisions an obstetrician makes at the bedside, namely, which agent, at which dose and route, and for how long, and the comparative evidence behind each. Contemporary practice descends from two protocols: the ampicillin-erythromycin regimen of the NICHD Maternal-Fetal Medicine Units Network trial and the erythromycin arm of ORACLE I. Neither was designed to identify an optimal regimen. Substitution of azithromycin for erythromycin rests predominantly on observational cohorts together with one small open-label randomised comparison that pre-specified no non-inferiority margin and is therefore pragmatic and guideline-permitted rather than confirmed by an adequately powered randomised trial. No randomised dose comparison using clinical endpoints has been performed in PPROM, although randomised pharmacokinetic data exist for azithromycin. The seven-day course derives from a trial protocol rather than from a duration-ranging study, and the two randomised duration comparisons published since 2023 point in opposite directions. Guideline agreement reflects shared historical ancestry rather than independent confirmation of optimality. Adequately powered pragmatic trials, stratified by gestational age, remain the principal unmet need.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.