MODERN ANTIBIOTIC THERAPY REGIMENS IN CHORIOAMNIONITIS: EFFICACY AND PERINATAL OUTCOMES

Abstract

Background: Chorioamnionitis (intra-amniotic infection) is a serious complication of pregnancy associated with significant maternal and neonatal morbidity. The optimal antibiotic regimen to mitigate these risks, particularly in the context of increasing antimicrobial resistance in the Fergana Valley, remains a subject of debate. This study compares the efficacy of a standard dual-therapy regimen versus an enhanced triple-therapy regimen. Methods: A prospective randomized controlled trial was conducted involving 150 pregnant women diagnosed with clinical chorioamnionitis. Participants were divided into two groups: Group A (n=75) received the standard regimen (Ampicillin + Gentamicin), while Group B (n=75) received an enhanced regimen (Ampicillin + Gentamicin + Clindamycin). Outcomes measured included time to defervescence, incidence of postpartum endometritis, and neonatal early-onset sepsis. Results: Group B demonstrated a significantly lower rate of postpartum endometritis (4.0% vs. 13.3%, p < 0.05) and wound infections following cesarean section compared to Group A. Time to maternal defervescence was shorter in Group B (3.5 ± 1.2 hours) vs Group A (5.8 ± 1.5 hours). Neonatal outcomes were comparable, but the triple-therapy group showed a trend towards reduced NICU admissions for suspected sepsis. Conclusion: The addition of an anaerobic agent (Clindamycin) to the standard Ampicillin/Gentamicin regimen provides superior maternal coverage, significantly reducing postpartum infectious complications, especially in women undergoing cesarean delivery.