Chatzakis C, et al. - In view of the observation that women with preterm prelabour rupture of membranes (PPROM) are routinely administered prophylactic antibiotics, researchers sought to compare the efficiency of different antibiotic regimens on perinatal outcomes via performing a network meta-analysis of 20 studies (7,169 participants randomized in 15 therapeutic regimens). In addition, they evaluated the quality of the current evidence. Compared with placebo/no treatment, the superior outcomes in terms of chorioamnionitis were achieved with clindamycin plus gentamycin, ampicillin-sulbactam plus amoxicillin-clavulanic acid, ampicillin, and erythromycin plus ampicillin plus amoxicillin. For neonatal sepsis, erythromycin was the only affective drug. For respiratory distress syndrome, the only effective regimens were clindamycin plus gentamicin and erythromycin plus ampicillin plus amoxicillin, whereas for reducing the rates of IVH ampicillin and penicillin were effective. In reducing the rates of neonatal death, perinatal death, and necrotizing enterocolitis, they identified none of the antibiotics as significantly more effective than placebo. Moderate to very low overall quality of the evidence per GRADE was noted; this depended on the outcome and comparison.