Abstract | OBJECTIVE: METHODS: Women with a clinical diagnosis of chorioamnionitis between 32 and 42 weeks of gestation were randomly assigned in labor to receive either daily gentamicin (5 mg/kg intravenously (IV), then 2 placebo doses IV after 8 and 16 hours) or 8-hour gentamicin (2 mg/kg IV, then 1.5 mg/kg IV after 8 and 16 hours). Both groups received ampicillin (2 grams IV every 6 hours for a total of four doses). Patients who underwent cesarean delivery also received clindamycin (900 mg IV every 8 hours, for a total of three doses). The primary outcome was treatment success, defined by resolution of chorioamnionitis after 16 hours of treatment without development of endometritis. One hundred twenty-six patients were required to have 95% confidence that daily gentamicin is at worst 15% inferior to 8-hour dosing with an alpha of .05 and a beta of 0.2. RESULTS: One hundred twenty-six women were enrolled, of whom 63 received daily gentamicin and 63 received 8-hour gentamicin. One patient was excluded from data analysis. Baseline maternal and obstetric characteristics were similar between groups except for longer mean duration of ruptured membranes in the 8-hour group (679+/-514 compared with 469+/-319 minutes; P =.03). Treatment success was equal between groups (94% daily gentamicin compared with 89% 8-hour gentamicin, P =.53). There were no differences in maternal or neonatal morbidities, including neonatal sepsis and newborn hearing screen. CONCLUSION: CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, www.clinicaltrials.gov, NCT00185991. LEVEL OF EVIDENCE: I.
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Authors | Deirdre J Lyell, Kristin Pullen, Katherine Fuh, A Musa Zamah, Aaron B Caughey, William Benitz, Yasser Y El-Sayed |
Journal | Obstetrics and gynecology
(Obstet Gynecol)
Vol. 115
Issue 2 Pt 1
Pg. 344-349
(Feb 2010)
ISSN: 1873-233X [Electronic] United States |
PMID | 20093909
(Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Anti-Bacterial Agents
- Gentamicins
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Topics |
- Adult
- Anti-Bacterial Agents
(administration & dosage)
- Chorioamnionitis
(drug therapy)
- Double-Blind Method
- Drug Administration Schedule
- Female
- Fetal Membranes, Premature Rupture
- Gentamicins
(administration & dosage)
- Humans
- Injections, Intravenous
- Pregnancy
- Pregnancy Trimester, Third
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