Incidence of neonatal infection in newborn infants with a maternal history of premature rupture of membranes (PROM) for 18 hours or longer by using Phramongkutklao Hospital Clinical Practice Guideline (CPG).

BACKGROUND: Phramongkutklao CPG was developed for detecting infants with maternal PROM > or = 18 hours who had a high risk of infection. OBJECTIVE: To determine efficacy of the CPG, and risk factors of infection. STUDY DESIGN: Prospective cohort study. MATERIAL AND METHOD: Eligible infants were categorized into group I (symptomatic), group II (chorioamnionitis) or group III (asymptomatic). Infants in group I, II and those in group III who had scores > or = 3 were treated with antibiotics. Infants were followed-up until 28 days of age. RESULTS: 104 infants were recruited into the present study. 29 of 104 (27.88%) infants had infection. Risk factors were Apgar scores < or = 5, PROM > 72 hours, gestational age < 34 weeks, and low birth weight. The success rate of using CPG was 98.08% and antibiotic use was reduced by 53.08%. CONCLUSION: Phramongkutklao CPG on PROM is safe and cost saving. All risk factors should be included in the guideline.