مقایسه‌ی اثر آزیترومایسین و اریترومایسین در کاهش عوارض پارگی زودرس کیسه آب: یک مطالعه‌ی کار آزمایی بالینی

نوع مقاله : Original Article(s)

نویسندگان

1 دانشجوی گروه زنان، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی شهید صدوقی یزد، یزد، ایران

2 دانشیار،گروه زنان، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی شهید صدوقی، یزد، ایران

3 استادیار، گروه آمار و اپیدمیولوژی، دانشکده‌ی بهداشت، دانشگاه علوم پزشکی شهید صدوقی یزد، یزد، ایران

چکیده

مقاله پژوهشی




مقدمه: پارگی زودرس پیش از موعد پرده‌های جنینی (Preterm premature rupture of membranes) PPROM یکی از علل مرگ‌ومیر پری ناتال می‌باشد. مطالعه‌ی حاضر با هدف مقایسه‌ی تأثیر آزیترومایسین و اریتروماسین بر روی پیامدهای بارداری در مادران مبتلا به PPROM انجام شد.
روش‌ها: در این کارآزمایی بالینی، مادران باردار با تشخیص PPROM با سن حاملگی 34-24 هفته تحت درمان با دو رژیم دارویی قرار گرفتند. گروه A (30 نفر) آزیترومایسین خوراکی یک گرم تک‌دوز و گروهB  (30 نفر) اریترومایسین خوراکی400 میلی‌گرم، هر 6 ساعت یکبار به مدت 7 روز دریافت کردند. همچنین هر دو گروه با 2 گرم آمپی‌سیلین وریدی هر 6 ساعت یکبار به مدت 48 ساعت و سپس آموکسی‌سیلین خوراکی 250 میلی‌گرم هر 8 ساعت یکبار به مدت 5 روز تحت درمان قرار گرفتند. سپس پیامد اولیه شامل زمان تأخیر و کوریوآمنیونیت کلینیکال و پیامد ثانویه شامل نوع زایمان، مایع آمنیون آغشته به مکونیوم، آندومتریت پست پارتوم، سپسیس نوزادی، نرخ تولد زنده و وزن نوزاد در دو گروه مقایسه شدند.
یافته‌ها: در گروه دریافت‌کننده‌ی آزیترومایسین در مقایسه با گروه دریافت‌کننده‌ی اریترومایسین، زمان تأخیر به‌طور معنی‌داری افزایش و آندومتریت پست پارتوم و سپسیس نوزادی با روش تشخیص آزمایشگاهی به‌طور معنی‌داری کاهش یافت. در حالی که در سایر عوارض، اختلاف آماری معنی‌داری بین دو گروه مشاهده نشد.
نتیجه‌گیری: یافته‌های این مطالعه نشان داد، آزیترومایسین در افزایش زمان تأخیر و کاهش آندومتریت پست پارتوم و سپسیس نوزادی در زنان مبتلابه PPROM مؤثرتر از اریترومایسین می‌باشد، بنابراین می‌تواند به‌عنوان جایگزین اریترومایسین در درمان پارگی زودرس کیسه‌ی آب استفاده شود.

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

Comparison of Azithromycin and Erythromycin Effects in Reducing Preterm Premature Rupture of Membranes Outcomes: A Clinical Trial Study

نویسندگان [English]

  • Mohadeseh Besharati 1
  • Atiyeh Javaheri 2
  • Noushin Hatamizadeh 2
  • Farimah Shamsi 3
1 Student of Obstetrics and Gynecology, Department of Obstetrics and Gynecology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
2 Associate Professor, Department of Obstetrics and Gynecology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
3 Assistant Professor, Department Biostatistics, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
چکیده [English]

Background: Preterm premature rupture of membranes (PPROM) is one of the important causes of perinatal mortality. This study aimed to compare the effects of azithromycin and erythromycin on pregnancy outcomes in mothers with PPROM.
Methods: In this clinical trial study, patients diagnosed with PPROM between 24 and 34 weeks were treated with two drug regimens. Group A (n = 30) received oral azithromycin one-gram single dose and Group B
(n = 30) received oral erythromycin 400 mg every 6 hr for 7 days. In addition, both groups were treated with intravenous ampicillin 2 grams every 6 hours for 48 hours and then amoxicillin 250 mg orally every 8 hours for 5 days. Primary outcomes including latency period and clinical chorioamnionitis and secondary outcomes including the type of delivery, amniotic fluid stained with meconium, postpartum endometritis, neonatal sepsis, baby's birth weight, and live birth rate were compared between the two groups.
Findings: In the current study, the latency period was significantly higher, while postpartum endometritis and laboratory-confirmed neonatal sepsis were significantly lower in the azithromycin group than in the erythromycin group. Other outcomes did not show significant differences between the two groups.
Conclusion: Azithromycin is more effective than erythromycin in the increased latency periods and decreased postpartum endometritis and neonatal sepsis in women with PPROM. Therefore, azithromycin can be a suitable alternative to erythromycin in the treatment of PPROM.

کلیدواژه‌ها [English]

  • Azithromycin
  • Erythromycin
  • PPROM
  • Pregnancy outcomes
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