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Cochrane Database of Systematic Reviews

Antibiotici za prsnuće vodenjaka prije termina

Información

DOI:
https://doi.org/10.1002/14651858.CD001058.pub3Copiar DOI
Base de datos:
  1. Cochrane Database of Systematic Reviews
Versión publicada:
  1. 02 diciembre 2013see what's new
Tipo:
  1. Intervention
Etapa:
  1. Review
Grupo Editorial Cochrane:
  1. Grupo Cochrane de Embarazo y parto

Copyright:
  1. Copyright © 2013 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

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Contraer

Autores

  • Sara Kenyon

    Correspondencia a: School of Health and Population Sciences, University of Birmingham, Edgbaston, UK

    [email protected]

  • Michel Boulvain

    Département de Gynécologie et d'Obstétrique, Unité de Développement en Obstétrique, Maternité Hôpitaux Universitaires de Genève, Genève 14, Switzerland

  • James P Neilson

    Department of Women's and Children's Health, The University of Liverpool, Liverpool, UK

Contributions of authors

Sara Kenyon assessed the relevant trials, abstracted the data and wrote the text of the review. Michel Boulvain and Jim Neilson checked the extracted data and helped write the review.

Sources of support

Internal sources

  • University of Liverpool, UK.

  • University of Geneva, Switzerland.

  • Leicester Royal Infirmary, UK.

  • University of Birmingham, UK.

External sources

  • UNDP‐UNFPA‐UNICEF‐WHO‐World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research (RHR), World Health Organization, Switzerland.

Declarations of interest

Sara Kenyon was the Co‐ordinator of the ORACLE Trial and led the ORACLE Children Study, both of which are included in this review.

Acknowledgements

We acknowledge assistance with the review from Therese Dowswell, Riccardo Pfister, Justus Hofmeyr, David Taylor, Ann Blackburn and Rebecca Smyth.

Therese Dowswell's work was financially supported by the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research (RHR), World Health Organization. The named authors alone are responsible for the views expressed in this publication.

As part of the pre‐publication editorial process, the review has been commented on by two peers (an editor and referee who is external to the editorial team), a member of the Pregnancy and Childbirth Group's international panel of consumers and the Group's Statistical Adviser.

The National Institute for Health Research (NIHR) is the largest single funder of the Cochrane Pregnancy and Childbirth Group. The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the NIHR, NHS or the Department of Health.

Version history

Published

Title

Stage

Authors

Version

2013 Dec 02

Antibiotics for preterm rupture of membranes

Review

Sara Kenyon, Michel Boulvain, James P Neilson

https://doi.org/10.1002/14651858.CD001058.pub3

2010 Aug 04

Antibiotics for preterm rupture of membranes

Review

Sara Kenyon, Michel Boulvain, James P Neilson

https://doi.org/10.1002/14651858.CD001058.pub2

2003 Apr 22

Antibiotics for preterm rupture of membranes

Review

Sara Kenyon, Michel Boulvain, James P Neilson

https://doi.org/10.1002/14651858.CD001058

Differences between protocol and review

Secondary outcome "Serious childhood disability at approximately two years" changed to "Serious childhood disability at seven years".

Keywords

MeSH

PICO

Population
Intervention
Comparison
Outcome

El uso y la enseñanza del modelo PICO están muy extendidos en el ámbito de la atención sanitaria basada en la evidencia para formular preguntas y estrategias de búsqueda y para caracterizar estudios o metanálisis clínicos. PICO son las siglas en inglés de cuatro posibles componentes de una pregunta de investigación: paciente, población o problema; intervención; comparación; desenlace (outcome).

Para saber más sobre el uso del modelo PICO, puede consultar el Manual Cochrane.

Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.
Figuras y tablas -
Figure 1

Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.

Funnel plot of comparison: 1 Any antibiotic versus placebo, outcome: 1.3 Perinatal death/death before discharge.
Figuras y tablas -
Figure 2

Funnel plot of comparison: 1 Any antibiotic versus placebo, outcome: 1.3 Perinatal death/death before discharge.

Funnel plot of comparison: 1 Any antibiotic versus placebo, outcome: 1.4 Neonatal infection including pneumonia.
Figuras y tablas -
Figure 3

Funnel plot of comparison: 1 Any antibiotic versus placebo, outcome: 1.4 Neonatal infection including pneumonia.

Funnel plot of comparison: 1 Any antibiotic versus placebo, outcome: 1.5 Neonatal necrotising enterocolitis.
Figuras y tablas -
Figure 4

Funnel plot of comparison: 1 Any antibiotic versus placebo, outcome: 1.5 Neonatal necrotising enterocolitis.

Funnel plot of comparison: 1 Any antibiotic versus placebo, outcome: 1.7 Major cerebral abnormality on ultrasound before discharge.
Figuras y tablas -
Figure 5

Funnel plot of comparison: 1 Any antibiotic versus placebo, outcome: 1.7 Major cerebral abnormality on ultrasound before discharge.

Comparison 1 Any antibiotic versus placebo, Outcome 1 Maternal death.
Figuras y tablas -
Analysis 1.1

Comparison 1 Any antibiotic versus placebo, Outcome 1 Maternal death.

Comparison 1 Any antibiotic versus placebo, Outcome 3 Perinatal death/death before discharge.
Figuras y tablas -
Analysis 1.3

Comparison 1 Any antibiotic versus placebo, Outcome 3 Perinatal death/death before discharge.

Comparison 1 Any antibiotic versus placebo, Outcome 4 Neonatal infection including pneumonia.
Figuras y tablas -
Analysis 1.4

Comparison 1 Any antibiotic versus placebo, Outcome 4 Neonatal infection including pneumonia.

Comparison 1 Any antibiotic versus placebo, Outcome 5 Neonatal necrotising enterocolitis.
Figuras y tablas -
Analysis 1.5

Comparison 1 Any antibiotic versus placebo, Outcome 5 Neonatal necrotising enterocolitis.

Comparison 1 Any antibiotic versus placebo, Outcome 6 Oxygen treatment > 36 weeks' postconceptual age.
Figuras y tablas -
Analysis 1.6

Comparison 1 Any antibiotic versus placebo, Outcome 6 Oxygen treatment > 36 weeks' postconceptual age.

Comparison 1 Any antibiotic versus placebo, Outcome 7 Major cerebral abnormality on ultrasound before discharge.
Figuras y tablas -
Analysis 1.7

Comparison 1 Any antibiotic versus placebo, Outcome 7 Major cerebral abnormality on ultrasound before discharge.

Comparison 1 Any antibiotic versus placebo, Outcome 8 Birth before 37 weeks' gestation.
Figuras y tablas -
Analysis 1.8

Comparison 1 Any antibiotic versus placebo, Outcome 8 Birth before 37 weeks' gestation.

Comparison 1 Any antibiotic versus placebo, Outcome 9 Major adverse drug reaction.
Figuras y tablas -
Analysis 1.9

Comparison 1 Any antibiotic versus placebo, Outcome 9 Major adverse drug reaction.

Comparison 1 Any antibiotic versus placebo, Outcome 10 Maternal infection after delivery prior to discharge.
Figuras y tablas -
Analysis 1.10

Comparison 1 Any antibiotic versus placebo, Outcome 10 Maternal infection after delivery prior to discharge.

Comparison 1 Any antibiotic versus placebo, Outcome 11 Chorioamnionitis.
Figuras y tablas -
Analysis 1.11

Comparison 1 Any antibiotic versus placebo, Outcome 11 Chorioamnionitis.

Comparison 1 Any antibiotic versus placebo, Outcome 12 Caesarean section.
Figuras y tablas -
Analysis 1.12

Comparison 1 Any antibiotic versus placebo, Outcome 12 Caesarean section.

Comparison 1 Any antibiotic versus placebo, Outcome 15 Birth within 48 hours of randomisation.
Figuras y tablas -
Analysis 1.15

Comparison 1 Any antibiotic versus placebo, Outcome 15 Birth within 48 hours of randomisation.

Comparison 1 Any antibiotic versus placebo, Outcome 16 Birth within 7 days of randomisation.
Figuras y tablas -
Analysis 1.16

Comparison 1 Any antibiotic versus placebo, Outcome 16 Birth within 7 days of randomisation.

Comparison 1 Any antibiotic versus placebo, Outcome 17 Birthweight.
Figuras y tablas -
Analysis 1.17

Comparison 1 Any antibiotic versus placebo, Outcome 17 Birthweight.

Comparison 1 Any antibiotic versus placebo, Outcome 18 Birthweight < 2500 g.
Figuras y tablas -
Analysis 1.18

Comparison 1 Any antibiotic versus placebo, Outcome 18 Birthweight < 2500 g.

Comparison 1 Any antibiotic versus placebo, Outcome 19 Neonatal intensive care.
Figuras y tablas -
Analysis 1.19

Comparison 1 Any antibiotic versus placebo, Outcome 19 Neonatal intensive care.

Comparison 1 Any antibiotic versus placebo, Outcome 20 Days in neonatal intensive care unit.
Figuras y tablas -
Analysis 1.20

Comparison 1 Any antibiotic versus placebo, Outcome 20 Days in neonatal intensive care unit.

Comparison 1 Any antibiotic versus placebo, Outcome 21 Positive neonatal blood culture.
Figuras y tablas -
Analysis 1.21

Comparison 1 Any antibiotic versus placebo, Outcome 21 Positive neonatal blood culture.

Comparison 1 Any antibiotic versus placebo, Outcome 22 Neonatal respiratory distress syndrome.
Figuras y tablas -
Analysis 1.22

Comparison 1 Any antibiotic versus placebo, Outcome 22 Neonatal respiratory distress syndrome.

Comparison 1 Any antibiotic versus placebo, Outcome 23 Treatment with surfactant.
Figuras y tablas -
Analysis 1.23

Comparison 1 Any antibiotic versus placebo, Outcome 23 Treatment with surfactant.

Comparison 1 Any antibiotic versus placebo, Outcome 24 Number of babies requiring ventilation.
Figuras y tablas -
Analysis 1.24

Comparison 1 Any antibiotic versus placebo, Outcome 24 Number of babies requiring ventilation.

Comparison 1 Any antibiotic versus placebo, Outcome 25 Number of babies requiring oxygen therapy.
Figuras y tablas -
Analysis 1.25

Comparison 1 Any antibiotic versus placebo, Outcome 25 Number of babies requiring oxygen therapy.

Comparison 1 Any antibiotic versus placebo, Outcome 26 Neonatal oxygenation > 28 days.
Figuras y tablas -
Analysis 1.26

Comparison 1 Any antibiotic versus placebo, Outcome 26 Neonatal oxygenation > 28 days.

Comparison 1 Any antibiotic versus placebo, Outcome 27 Neonatal encephalopathy.
Figuras y tablas -
Analysis 1.27

Comparison 1 Any antibiotic versus placebo, Outcome 27 Neonatal encephalopathy.

Comparison 1 Any antibiotic versus placebo, Outcome 28 Serious childhood disability at 7 years.
Figuras y tablas -
Analysis 1.28

Comparison 1 Any antibiotic versus placebo, Outcome 28 Serious childhood disability at 7 years.

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 3 Major adverse drug reaction.
Figuras y tablas -
Analysis 2.3

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 3 Major adverse drug reaction.

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 4 Maternal infection after delivery prior to discharge.
Figuras y tablas -
Analysis 2.4

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 4 Maternal infection after delivery prior to discharge.

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 6 Caesarean section.
Figuras y tablas -
Analysis 2.6

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 6 Caesarean section.

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 9 Birth within 48 hours of randomisation.
Figuras y tablas -
Analysis 2.9

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 9 Birth within 48 hours of randomisation.

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 10 Birth within 7 days of randomisation.
Figuras y tablas -
Analysis 2.10

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 10 Birth within 7 days of randomisation.

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 11 Birth before 37 weeks' gestation.
Figuras y tablas -
Analysis 2.11

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 11 Birth before 37 weeks' gestation.

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 12 Birthweight.
Figuras y tablas -
Analysis 2.12

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 12 Birthweight.

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 13 Birthweight < 2500 g.
Figuras y tablas -
Analysis 2.13

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 13 Birthweight < 2500 g.

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 14 Neonatal intensive care.
Figuras y tablas -
Analysis 2.14

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 14 Neonatal intensive care.

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 17 Positive neonatal blood culture.
Figuras y tablas -
Analysis 2.17

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 17 Positive neonatal blood culture.

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 18 Neonatal necrotising enterocolitis.
Figuras y tablas -
Analysis 2.18

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 18 Neonatal necrotising enterocolitis.

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 19 Neonatal respiratory distress syndrome.
Figuras y tablas -
Analysis 2.19

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 19 Neonatal respiratory distress syndrome.

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 20 Treatment with surfactant.
Figuras y tablas -
Analysis 2.20

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 20 Treatment with surfactant.

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 21 Number of babies requiring ventilation.
Figuras y tablas -
Analysis 2.21

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 21 Number of babies requiring ventilation.

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 22 Number of babies requiring oxygen therapy.
Figuras y tablas -
Analysis 2.22

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 22 Number of babies requiring oxygen therapy.

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 23 Neonatal oxygenation > 28 days.
Figuras y tablas -
Analysis 2.23

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 23 Neonatal oxygenation > 28 days.

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 24 Oxygen treatment > 36 weeks' postconceptual age.
Figuras y tablas -
Analysis 2.24

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 24 Oxygen treatment > 36 weeks' postconceptual age.

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 26 Major cerebral abnormality on ultrasound before discharge.
Figuras y tablas -
Analysis 2.26

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 26 Major cerebral abnormality on ultrasound before discharge.

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 27 Perinatal death/death before discharge.
Figuras y tablas -
Analysis 2.27

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 27 Perinatal death/death before discharge.

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 28 Serious childhood disability at 7 years.
Figuras y tablas -
Analysis 2.28

Comparison 2 Erythromycin versus co‐amoxiclav, Outcome 28 Serious childhood disability at 7 years.

Comparison 4 Antibiotics versus no antibiotic, Outcome 1 Perinatal death/death before discharge.
Figuras y tablas -
Analysis 4.1

Comparison 4 Antibiotics versus no antibiotic, Outcome 1 Perinatal death/death before discharge.

Comparison 5 3 versus 7 day ampicillin regimens, Outcome 4 Maternal infection after delivery prior to discharge.
Figuras y tablas -
Analysis 5.4

Comparison 5 3 versus 7 day ampicillin regimens, Outcome 4 Maternal infection after delivery prior to discharge.

Comparison 5 3 versus 7 day ampicillin regimens, Outcome 5 Chorioamnionitis.
Figuras y tablas -
Analysis 5.5

Comparison 5 3 versus 7 day ampicillin regimens, Outcome 5 Chorioamnionitis.

Comparison 5 3 versus 7 day ampicillin regimens, Outcome 6 Caesarean section.
Figuras y tablas -
Analysis 5.6

Comparison 5 3 versus 7 day ampicillin regimens, Outcome 6 Caesarean section.

Comparison 5 3 versus 7 day ampicillin regimens, Outcome 9 Birth within 48 hours of randomisation.
Figuras y tablas -
Analysis 5.9

Comparison 5 3 versus 7 day ampicillin regimens, Outcome 9 Birth within 48 hours of randomisation.

Comparison 5 3 versus 7 day ampicillin regimens, Outcome 10 Birth within 7 days of randomisation.
Figuras y tablas -
Analysis 5.10

Comparison 5 3 versus 7 day ampicillin regimens, Outcome 10 Birth within 7 days of randomisation.

Comparison 5 3 versus 7 day ampicillin regimens, Outcome 14 Neonatal intensive care.
Figuras y tablas -
Analysis 5.14

Comparison 5 3 versus 7 day ampicillin regimens, Outcome 14 Neonatal intensive care.

Comparison 5 3 versus 7 day ampicillin regimens, Outcome 18 Neonatal necrotising enterocolitis.
Figuras y tablas -
Analysis 5.18

Comparison 5 3 versus 7 day ampicillin regimens, Outcome 18 Neonatal necrotising enterocolitis.

Comparison 5 3 versus 7 day ampicillin regimens, Outcome 19 Neonatal respiratory distress syndrome.
Figuras y tablas -
Analysis 5.19

Comparison 5 3 versus 7 day ampicillin regimens, Outcome 19 Neonatal respiratory distress syndrome.

Comparison 5 3 versus 7 day ampicillin regimens, Outcome 26 Neonatal intraventricular haemorrhage.
Figuras y tablas -
Analysis 5.26

Comparison 5 3 versus 7 day ampicillin regimens, Outcome 26 Neonatal intraventricular haemorrhage.

Comparison 5 3 versus 7 day ampicillin regimens, Outcome 27 Perinatal death/death before discharge.
Figuras y tablas -
Analysis 5.27

Comparison 5 3 versus 7 day ampicillin regimens, Outcome 27 Perinatal death/death before discharge.

Comparison 1. Any antibiotic versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Maternal death Show forest plot

3

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

1.1 Any antibiotic versus placebo

3

763

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.2 All penicillin (excluding co‐amoxiclav) versus placebo

1

85

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.3 Beta lactum (including co‐amoxiclav) versus placebo 

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.4 Macrolide (including erythromycin) versus placebo

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.5 Other antibiotic versus placebo

2

678

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2 Serious maternal morbidity

0

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

2.1 Any antibiotic versus placebo

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2.2 All penicillin (excluding co‐amoxiclav) versus placebo

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2.3 Beta lactum (including co‐amoxiclav) versus placebo

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2.4 Macrolide (including erythromycin) versus placebo

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2.5 Other antibiotic versus placebo

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

3 Perinatal death/death before discharge Show forest plot

12

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

3.1 Any antibiotic versus placebo

12

6301

Risk Ratio (M‐H, Random, 95% CI)

0.93 [0.76, 1.14]

3.2 All penicillin (excluding co‐amoxiclav) versus placebo

4

332

Risk Ratio (M‐H, Random, 95% CI)

0.78 [0.31, 1.97]

3.3 Beta lactum (including co‐amoxiclav) versus placebo

2

1880

Risk Ratio (M‐H, Random, 95% CI)

0.62 [0.15, 2.56]

3.4 Macrolide (including erythromycin) versus placebo

4

2138

Risk Ratio (M‐H, Random, 95% CI)

0.83 [0.43, 1.60]

3.5 Other antibiotic versus placebo

3

762

Risk Ratio (M‐H, Random, 95% CI)

1.13 [0.68, 1.88]

4 Neonatal infection including pneumonia Show forest plot

12

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

4.1 Any antibiotic versus placebo

12

1680

Risk Ratio (M‐H, Random, 95% CI)

0.67 [0.52, 0.85]

4.2 All penicillin (excluding co‐amoxiclav) versus placebo

5

521

Risk Ratio (M‐H, Random, 95% CI)

0.30 [0.13, 0.68]

4.3 Beta lactum (including co‐amoxiclav) versus placebo

1

62

Risk Ratio (M‐H, Random, 95% CI)

0.33 [0.01, 7.88]

4.4 Macrolide (including erythromycin) versus placebo

3

334

Risk Ratio (M‐H, Random, 95% CI)

0.79 [0.45, 1.37]

4.5 Other antibiotic versus placebo

3

763

Risk Ratio (M‐H, Random, 95% CI)

0.71 [0.53, 0.95]

5 Neonatal necrotising enterocolitis Show forest plot

11

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

5.1 Any antibiotic versus placebo

11

6229

Risk Ratio (M‐H, Random, 95% CI)

1.09 [0.65, 1.83]

5.2 All penicillin (excluding co‐amoxiclav) versus placebo

3

262

Risk Ratio (M‐H, Random, 95% CI)

0.85 [0.25, 2.97]

5.3 Beta lactum (including co‐amoxiclav) versus placebo

2

1880

Risk Ratio (M‐H, Random, 95% CI)

4.72 [1.57, 14.23]

5.4 Macrolide (including erythromycin) versus placebo

3

2076

Risk Ratio (M‐H, Random, 95% CI)

0.88 [0.45, 1.69]

5.5 Other antibiotic versus placebo

4

823

Risk Ratio (M‐H, Random, 95% CI)

0.89 [0.54, 1.47]

6 Oxygen treatment > 36 weeks' postconceptual age Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

6.1 Any antibiotic versus placebo

1

4809

Risk Ratio (M‐H, Random, 95% CI)

0.91 [0.70, 1.17]

6.2 All penicillin (excluding co‐amoxiclav) versus placebo

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

6.3 Beta lactum (including co‐amoxiclav) versus placebo

1

1818

Risk Ratio (M‐H, Random, 95% CI)

0.92 [0.63, 1.36]

6.4 Macrolide (including erythromycin) versus placebo

1

1803

Risk Ratio (M‐H, Random, 95% CI)

0.89 [0.61, 1.32]

6.5 Other antibiotic versus placebo

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

7 Major cerebral abnormality on ultrasound before discharge Show forest plot

12

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

7.1 Any antibiotic versus placebo

12

6289

Risk Ratio (M‐H, Random, 95% CI)

0.81 [0.68, 0.98]

7.2 All penicillin (excluding co‐amoxiclav) versus placebo 

3

262

Risk Ratio (M‐H, Random, 95% CI)

0.49 [0.25, 0.96]

7.3 Beta lactum (including co‐amoxiclav) versus placebo

2

1880

Risk Ratio (M‐H, Random, 95% CI)

0.78 [0.52, 1.16]

7.4 Macrolide (including erythromycin) versus placebo 

4

2136

Risk Ratio (M‐H, Random, 95% CI)

0.93 [0.60, 1.44]

7.5 Other antibiotic versus placebo

4

823

Risk Ratio (M‐H, Random, 95% CI)

0.85 [0.45, 1.64]

8 Birth before 37 weeks' gestation Show forest plot

3

4931

Risk Ratio (M‐H, Random, 95% CI)

1.00 [0.98, 1.03]

9 Major adverse drug reaction Show forest plot

3

5487

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

10 Maternal infection after delivery prior to discharge Show forest plot

4

5547

Risk Ratio (M‐H, Random, 95% CI)

0.91 [0.80, 1.02]

11 Chorioamnionitis Show forest plot

11

1559

Risk Ratio (M‐H, Random, 95% CI)

0.66 [0.46, 0.96]

12 Caesarean section Show forest plot

11

6317

Risk Ratio (M‐H, Random, 95% CI)

0.96 [0.88, 1.05]

13 Days from birth till discharge of mother

0

0

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

14 Days from randomisation to birth

0

0

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

15 Birth within 48 hours of randomisation Show forest plot

7

5927

Risk Ratio (M‐H, Random, 95% CI)

0.71 [0.58, 0.87]

16 Birth within 7 days of randomisation Show forest plot

7

5965

Risk Ratio (M‐H, Random, 95% CI)

0.79 [0.71, 0.89]

17 Birthweight Show forest plot

12

6374

Mean Difference (IV, Random, 95% CI)

53.83 [7.06, 100.60]

18 Birthweight < 2500 g Show forest plot

2

4876

Risk Ratio (M‐H, Random, 95% CI)

1.00 [0.96, 1.04]

19 Neonatal intensive care Show forest plot

4

5023

Risk Ratio (M‐H, Random, 95% CI)

0.98 [0.84, 1.13]

20 Days in neonatal intensive care unit Show forest plot

3

225

Mean Difference (IV, Random, 95% CI)

‐5.05 [‐9.77, ‐0.33]

21 Positive neonatal blood culture Show forest plot

3

4961

Risk Ratio (M‐H, Random, 95% CI)

0.79 [0.63, 0.99]

22 Neonatal respiratory distress syndrome Show forest plot

12

6287

Risk Ratio (M‐H, Random, 95% CI)

0.95 [0.83, 1.09]

23 Treatment with surfactant Show forest plot

1

4809

Risk Ratio (M‐H, Random, 95% CI)

0.83 [0.72, 0.96]

24 Number of babies requiring ventilation Show forest plot

2

4924

Risk Ratio (M‐H, Random, 95% CI)

0.90 [0.80, 1.02]

25 Number of babies requiring oxygen therapy Show forest plot

1

4809

Risk Ratio (M‐H, Random, 95% CI)

0.88 [0.81, 0.96]

26 Neonatal oxygenation > 28 days Show forest plot

3

5487

Risk Ratio (M‐H, Random, 95% CI)

0.79 [0.61, 1.03]

27 Neonatal encephalopathy Show forest plot

1

60

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

28 Serious childhood disability at 7 years Show forest plot

1

3171

Risk Ratio (M‐H, Random, 95% CI)

1.01 [0.91, 1.12]

Figuras y tablas -
Comparison 1. Any antibiotic versus placebo
Comparison 2. Erythromycin versus co‐amoxiclav

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Maternal death

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2 Serious maternal morbidity

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

3 Major adverse drug reaction Show forest plot

1

2395

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

4 Maternal infection after delivery prior to discharge Show forest plot

1

2395

Risk Ratio (M‐H, Random, 95% CI)

1.02 [0.87, 1.20]

5 Chorioamnionitis

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

6 Caesarean section Show forest plot

1

2395

Risk Ratio (M‐H, Random, 95% CI)

1.02 [0.90, 1.16]

7 Days from randomisation to birth

0

0

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

8 Days from birth till discharge of mother

0

0

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

9 Birth within 48 hours of randomisation Show forest plot

1

2395

Risk Ratio (M‐H, Random, 95% CI)

1.14 [1.02, 1.28]

10 Birth within 7 days of randomisation Show forest plot

1

2395

Risk Ratio (M‐H, Random, 95% CI)

1.06 [0.99, 1.13]

11 Birth before 37 weeks' gestation Show forest plot

1

2395

Risk Ratio (M‐H, Random, 95% CI)

0.99 [0.96, 1.03]

12 Birthweight Show forest plot

1

2395

Mean Difference (IV, Random, 95% CI)

19.0 [‐41.92, 79.92]

13 Birthweight < 2500 g Show forest plot

1

2395

Risk Ratio (M‐H, Random, 95% CI)

1.00 [0.95, 1.05]

14 Neonatal intensive care Show forest plot

1

2395

Risk Ratio (M‐H, Random, 95% CI)

1.00 [0.95, 1.05]

15 Days in neonatal intensive care unit

0

0

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

16 Neonatal infection including pneumonia

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

17 Positive neonatal blood culture Show forest plot

1

2395

Risk Ratio (M‐H, Random, 95% CI)

0.84 [0.62, 1.15]

18 Neonatal necrotising enterocolitis Show forest plot

1

2395

Risk Ratio (M‐H, Random, 95% CI)

0.46 [0.23, 0.94]

19 Neonatal respiratory distress syndrome Show forest plot

1

2395

Risk Ratio (M‐H, Random, 95% CI)

0.99 [0.84, 1.16]

20 Treatment with surfactant Show forest plot

1

2395

Risk Ratio (M‐H, Random, 95% CI)

0.98 [0.81, 1.19]

21 Number of babies requiring ventilation Show forest plot

1

2395

Risk Ratio (M‐H, Random, 95% CI)

1.00 [0.86, 1.17]

22 Number of babies requiring oxygen therapy Show forest plot

1

2395

Risk Ratio (M‐H, Random, 95% CI)

0.98 [0.87, 1.10]

23 Neonatal oxygenation > 28 days Show forest plot

1

2395

Risk Ratio (M‐H, Random, 95% CI)

0.86 [0.66, 1.12]

24 Oxygen treatment > 36 weeks' postconceptual age Show forest plot

1

2395

Risk Ratio (M‐H, Random, 95% CI)

0.97 [0.70, 1.34]

25 Neonatal encephalopathy

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

26 Major cerebral abnormality on ultrasound before discharge Show forest plot

1

2395

Risk Ratio (M‐H, Random, 95% CI)

1.10 [0.74, 1.63]

27 Perinatal death/death before discharge Show forest plot

1

2395

Risk Ratio (M‐H, Random, 95% CI)

0.90 [0.66, 1.23]

28 Serious childhood disability at 7 years Show forest plot

1

1612

Risk Ratio (M‐H, Random, 95% CI)

0.89 [0.79, 1.01]

Figuras y tablas -
Comparison 2. Erythromycin versus co‐amoxiclav
Comparison 4. Antibiotics versus no antibiotic

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Perinatal death/death before discharge Show forest plot

18

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

1.1 Antibiotics versus no antibiotics (all studies)

18

6872

Risk Ratio (M‐H, Random, 95% CI)

0.89 [0.74, 1.08]

1.2 Antibiotics versus no treatment (no placebo)

6

571

Risk Ratio (M‐H, Random, 95% CI)

0.69 [0.41, 1.14]

Figuras y tablas -
Comparison 4. Antibiotics versus no antibiotic
Comparison 5. 3 versus 7 day ampicillin regimens

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Maternal death

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2 Serious maternal morbidity

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

3 Major adverse drug reaction

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

4 Maternal infection after delivery prior to discharge Show forest plot

1

84

Risk Ratio (M‐H, Random, 95% CI)

1.25 [0.36, 4.33]

5 Chorioamnionitis Show forest plot

1

84

Risk Ratio (M‐H, Random, 95% CI)

0.73 [0.33, 1.63]

6 Caesarean section Show forest plot

1

84

Risk Ratio (M‐H, Random, 95% CI)

1.18 [0.72, 1.91]

7 Days from randomisation to birth

0

0

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

8 Days from birth till discharge of mother

0

0

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

9 Birth within 48 hours of randomisation Show forest plot

1

84

Risk Ratio (M‐H, Random, 95% CI)

1.14 [0.46, 2.87]

10 Birth within 7 days of randomisation Show forest plot

1

84

Risk Ratio (M‐H, Random, 95% CI)

1.0 [0.70, 1.42]

11 Birth before 37 weeks' gestation

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

12 Birthweight

0

0

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

13 Birthweight < 2500 g

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

14 Neonatal intensive care Show forest plot

1

84

Risk Ratio (M‐H, Random, 95% CI)

1.0 [0.84, 1.19]

15 Days in neonatal intensive care unit

0

0

Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

16 Neonatal infection including pneumonia

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

17 Positive neonatal blood culture

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

18 Neonatal necrotising enterocolitis Show forest plot

2

130

Risk Ratio (M‐H, Random, 95% CI)

0.43 [0.07, 2.86]

19 Neonatal respiratory distress syndrome Show forest plot

2

130

Risk Ratio (M‐H, Random, 95% CI)

0.96 [0.62, 1.49]

20 Treatment with surfactant

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

21 Number of babies requiring ventilation

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

22 Number of babies requiring oxygen therapy

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

23 Neonatal oxygenation > 28 days

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

24 Oxygen treatment > 36 weeks' postconceptual age

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

25 Neonatal encephalopathy

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

26 Neonatal intraventricular haemorrhage Show forest plot

2

130

Risk Ratio (M‐H, Random, 95% CI)

0.33 [0.04, 3.12]

27 Perinatal death/death before discharge Show forest plot

2

130

Risk Ratio (M‐H, Random, 95% CI)

0.40 [0.05, 2.94]

28 Serious childhood disability at 7 years

0

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

Figuras y tablas -
Comparison 5. 3 versus 7 day ampicillin regimens