Antibiotic Therapy Increases the Risk of Preterm Birth in Preterm Labor without Intra-Amniotic Microbes, but may Prolong the Gestation Period in Preterm Labor with Microbes, Evaluated by Rapid and High-Sensitive PCR System

ObjectivesTo examine the efficacy of the use of antibiotics in preterm labor (PTL) with intact membranes, after evaluating intra-amniotic microbes by our rapid and bacteria-free polymerase chain reaction (PCR) system. Materials and methodsOne hundred and four PTL patients before 32 weeks of gestation were recruited. Until 2012, antibiotics were empirically prescribed based on the clinical severity of PTL. Intra-amniotic microbes in stored samples were evaluated later by our newly established PCR system, and the efficacy of the use of antibiotics in PTL was evaluated. ResultsIn the amniotic fluid (AF) microbe-negative patients (n = 67), antibiotic therapy significantly shortened the gestation period (P < 0.0001), whereas in the microbe-positive patients (n = 37), appropriate antibiotic therapy (proper antibiotic selection against identified AF microbes) was significantly associated with an increase in gestation period (P < 0.0001). ConclusionAppropriate antibiotic therapy in PTL with intact membranes prolonged the gestation period.