Antibiotics in the Management of PROM and Preterm Labor

A significant fraction of preterm birth results from subclinical intrauterine infection. Antimicrobial treatment during conservative management of preterm labor and premature rupture of the membranes (PROM) remote from term could treat subclinical decidual colonization. There are data supporting adjunctive antibiotic treatment during conservative management of PROM remote from term, including broad-spectrum agents. There is no consistent evidence that antibiotic treatment in the setting of preterm labor with intact membranes prolongs pregnancy or improves newborn outcomes; there is some evidence of risk. Antibiotic treatment for pregnancy prolongation should not be offered in the setting of preterm labor with intact membranes.