LAUSR

OBJECTIVE To estimate the effect of erythromycin versus azithromycin on the duration of latency and the rate of clinical chorioamnionitis in women with preterm prelabor rupture of membranes by performing a systematic review and meta-analysis of the existing literature. DATA SOURCES From inception through October 2021, we explored MEDLINE, Scopus, Embase, CINAHL, ClinicalTrials.gov and Cochrane Central Register of Controlled Trials. STUDY ELIGIBILITY Studies comparing the duration of latency and the rate of clinical chorioamnionitis in women with preterm prelabor rupture of membranes that were treated with erythromycin versus azithromycin at the time of diagnosis were included. STUDY APPRAISAL AND SYNTHESIS METHODS Two reviewers separately ascertained studies, obtained data, and gauged study quality. The mean length of latency or the rate of clinical chorioamnionitis were compared and mean differences or odds ratios (ORs) with 95% confidence intervals (CIs) were estimated. RESULTS Five studies with 1,289 women were identified. The mean length of latency in women with preterm prelabor rupture of membranes was similar in individuals treated with erythromycin versus azithromycin; 6.6 days versus 6.7 days (mean difference 0.07 days, 95% CI -0.45 to 0.60, I2 0%). The median point prevalence of clinical chorioamnionitis was 25% (median 95% CI 12% to 32%) in women who had received erythromycin compared to 14% (median 95% CI 9% to 24%) in women who were administered azithromycin. The overall clinical chorioamnionitis rate in women that had been given azithromycin was lower compared to women that had received erythromycin (pooled OR 0.53, 95% CI 0.39 to 0.71, I2 0%). CONCLUSIONS Administration of azithromycin in women with preterm prelabor rupture of membranes is associated with a similar latency period but a lower rate of clinical chorioamnionitis when compared to erythromycin.