PI has decided to end study due to changes in Texas law and no participants were enrolled

The purpose of this study is to see if the use of prophylactic antibiotics in the expectant management of PPROM less than 22 weeks significantly reduce the rate of delivery within 7 days and to see if the use of prophylactic antibiotics in the expectant management of PPROM between 20 and 22 weeks decrease composite neonatal morbidity.

Inclusion Criteria:

• Preterm premature rupture of membranes at less than 22 weeks.
• Membrane rupture had occurred within 36 hours of randomization.
• Cervical dilatation is 3 cm or less (on visual or clinical examination).
• 4 or fewer contractions in the 60-minute monitoring period before randomization.
• Singleton gestation. Twin gestation reduced to singleton, either spontaneously or therapeutically, is not eligible unless the reduction occurred before 14 weeks project gestational age
• Gestational age at randomization less than 22 weeks (≤21 weeks and 6 days) based on clinical information.

Exclusion Criteria:

• Nonreasoning fetal testing
• Vaginal bleeding
• Maternal or fetal indication for immediate delivery
• Cervical cerclage in place
• Receipt of latency antibiotics prior to randomization (azithromycin, ampicillin, or amoxicillin)
• Allergy to Penicillins or Azithromycin
• Febrile illness requiring antibiotics
• Placenta previa
• Multifetal gestation