Bibliographic Info
GuidelineWHO recommendations on maternal health: guidelines approved by the WHO Guidelines Review Committee, second edition. Geneva: World Health Organization; 2025
Year of Publication2023
Issuing InstitutionWorld Health Organization
Recommendation
Status
Maintained
Recommended in favor
Conditional
Certainty of evidence
Moderate
Erythromycin is recommended as the antibiotic of choice for prophylaxis in women with preterm prelabour rupture of membranes
Notes and Remarks
- 1.The GDG acknowledged the paucity of evidence from the subgroup analysis to demonstrate comparative effectiveness of different classes and regimens of antibiotics used for prophylaxis in women with preterm prelabour rupture of membranes (PPROM). However, the choice of erythromycin was based on the findings of a study (the ORACLE I trial) with over 2000 women, which showed that erythromycin lessens the risk of necrotizing enterocolitis (NEC) in the newborn compared to co-amoxiclav. The recommendation was made conditional because antibiotic choice may be dependent on local availability of the drug and sensitivities of prevalent organisms.
- 2.For antibiotic prophylaxis in women with PPROM, oral erythromycin 250 mg four times a day for 10 days (or until delivery) should be used. The choice of this regimen was informed by the regimen used in the ORACLE I trial.
- 3.The management of group B streptococcal colonization is outside the scope of this guideline. However, when considering colonization with group B streptococcus, management decisions should be taken based on adequate microbiological coverage and sensitivities.
Also Featured In
This recommendation also appears in the following guidelines:
Originally Developed
Guideline
WHO recommendations on interventions to improve preterm birth outcomes
Year2015
InstitutionWorld Health Organization