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March 11, 1998

Antibiotic Therapy for Premature Rupture of Membranes to Prevent Respiratory Distress Syndrome—Reply

Author Affiliations

Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor

JAMA. 1998;279(10):748-749. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-10-jac80000

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.

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