Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor
In Reply.—Dr Cimolai raises several important
issues, including the possibility that antibiotics will be ineffective in
reducing infant morbidity if corticosteroids are administered and that antibiotic
treatment may lead to bacterial resistance.
Respiratory distress syndrome (RDS) is the most common serious morbidity
affecting preterm infants. Maternally administered corticosteroids have been
shown to reduce the frequency of RDS by a factor of 0.41 in unselected patients
and 0.45 in the setting of PPROM.1 However,
the beneficial impact of corticosteroids after PPROM has been questioned,2 and their use after PPROM has not been fully endorsed
by the American College of Obstetricians and Gynecologists. Even if corticosteroids
are useful after PPROM, they are not universally effective. The RDS will remain
the most common serious morbidity affecting this population.
Mercer BM, Thom EA, Goldenberg RL. Antibiotic Therapy for Premature Rupture of Membranes to Prevent Respiratory Distress Syndrome—Reply. JAMA. 1998;279(10):748-749. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-10-jac80000