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.