AzTrials
AzTrials

PPROMPROMOATNCT06906757

Preterm Rupture of Membranes Optimising Antibiotics Trial

A study testing Erythromycin 250mg and Amoxicillin 500mg in people with PPROM and Preterm, run by University of Melbourne.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
Search all trials

Trial summary

The goal of this clinical trial is to learn which antibiotic regimen works best to prevent infection in pregnant women whose waters break early (preterm, pre-labour rupture of membranes, or PPROM) and assess the health outcomes of babies born to pregnant women who have received these antibiotics. Read more about this study

Who is it for?
Any age, women only
Conditions the study is for
PPROM, Preterm
What is being tested?
Erythromycin 250mg and Amoxicillin 500mg
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
3,900 participants
Where
No sites listed yet
Study dates
Sep 2025to Dec 2050
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Any age
  • Women only
  • No healthy volunteers
  • Child, Adult, Older adult

PLATFORM ELIGIBILITY

Participants must meet all core PLATIPUS platform inclusion criteria:

  • Considered to be at risk of birth before 37 weeks gestation (spontaneous and provider-initiated)
  • Receiving pregnancy care at a participating site (hospital) at the time of eligibility assessment and
  • Meet eligibility criteria for one or more platform domains.

Participants will be excluded from participation if they meet any core PLATIPUS platform exclusion criteria:

  • Inability to consent for themselves
  • Perinatal death is deemed to be imminent and inevitable during the next 24 hours (at time of screening).

Pregnant women and people who meet ALL of the core platform inclusion criteria and none of the exclusion criteria will be considered for PROMOAT-specific eligibility.

PROMOAT-SPECIFIC ELIGIBILITY

Platform-eligible participants must meet all PROMOAT-specific inclusion criteria:

  1. Women with singleton or multiple pregnancies complicated by preterm prelabour rupture of membranes (PPROM) < 37+0 weeks' gestation as determined by the treating clinician and standard criteria:
  • Maternal history consistent with loss of fluid per vagina
  • Evidence of a pool of fluid in the vagina on sterile speculum examination
  • +/- positive testing for IGFBP-1 (Actim PROM) or PAMG-1 (Amnisure) AND
  1. Are eligible for at least two treatment arms within the domain
  2. The fetus/fetuses are alive at randomisation
  3. The pregnancy is continuing and active neonatal management is planned.

Participants will be excluded from participation if they meet core PLATIPUS platform exclusion criteria:

  • Inability to consent for themselves OR
  • Perinatal death is deemed to be imminent and inevitable during the next 24 hours (at time of screening).

Participants will be excluded from participation if they meet any PROMOAT-specific exclusion criteria:

  1. Antibiotic treatment for > 24 hours administered with the aim of preventing infection from PPROM
  2. Suspected maternal or fetal infection (chorioamnionitis)
  3. Maternal or fetal indication for immediate birth
  4. Established preterm labour (cervical dilatation ≥ 3cm AND regular contractions)
  5. No appropriate antibiotic available within domain intervention arms due to allergy, contraindications, drug interactions, drug availability, or previous history of antibiotic-resistant infection/s
  6. Women with a previous infant affected by GBS sepsis
  7. Major congenital fetal anomaly.

Platform-eligible participants who meet all PROMOAT-specific inclusion criteria and none of the PROMOAT-specific exclusion criteria will be eligible to participate in PROMOAT.

Trial locations and contacts

No sites are listed yet. Contact the study team or a site near you to ask about taking part.

Clare Whitehead, MBChB, PhD contact

00610383452000

clarew@unimelb.edu.au

About this study

Official title: Preterm Rupture of Membranes Optimising Antibiotics Trial (PROMOAT). A Pregnancy Domain Within PLATIPUS.

The goal of this clinical trial is to learn which antibiotic regimen works best to prevent infection in pregnant women whose waters break early (preterm, pre-labour rupture of membranes, or PPROM) and assess the health outcomes of babies born to pregnant women who have received these antibiotics.

PROMOAT aims to answer the question: Which antibiotic or combined antibiotic regimen most effectively prevents infection in pregnant women with PPROM < 37+0 weeks' gestation.

Read more

Researchers will compare three antibiotic regimens already used in clinical practice to prevent infection in pregnant women with PPROM.

Participants will be randomly allocated to the antibiotic regimen they will follow for seven days, or until birth (whichever is earlier). All antibiotics will be taken orally.

Neonatal health outcomes will be collected at 42 weeks postmenstrual age and maternal birth and postpartum care outcomes assessed at 42 days postpartum.

Questionnaires will capture maternal mood at time of consent and at 42 days postpartum. Antibiotic tolerance will be assessed at the time antibiotic treatment is ceased.

This trial will be undertaken as part of the PLATIPUS trial (NCT06461429).

Read the detailed description

PROMOAT aims to determine which of the most common antibiotic regimens are most effective in preventing infection in pregnant people with PPROM to improve health outcomes for their infants. PROMOAT is a pregnancy domain within the PLATIPUS adaptive platform trial (NCT06461429).

Preterm prelabour rupture of membranes (PPROM) precedes 30-40% of spontaneous preterm births and is an important cause of maternal and neonatal infection. Membrane rupture provides an entry point for microbes from the vagina to ascend into the uterine cavity, exposing the mother and the fetus to infectious pathogens leading to poor maternal and neonatal outcomes. Mothers with PPROM are at increased risk of haemorrhage, hysterectomy, sepsis, intensive care admission and death. Preterm infants exposed to in-utero infection are at higher risk of poor short- and long-term outcomes, including neonatal sepsis, neurodevelopmental delay, cerebral palsy, chronic lung disease and death.

Neonatal sepsis is the third most common cause of newborn deaths (~340,000 per year) and prevention is a major research priority, Neonatal sepsis due to pathogens acquired after PPROM may present in the first days of life and result in bacteraemia, pneumonia and meningitis. The most common pathogens associated with early-onset neonatal sepsis are Streptococcus agalactiae (aka Group B Streptococcus: GBS), Escherichia coli and Ureaplasma sp. Mortality is highest in the most immature infants, with a 54% case fatality rate in infants born before 24 weeks' gestation.

The goal in managing pregnancies complicated by PPROM is to prolong the pregnancy to enable fetal maturity without an increased risk of infection (acquired while the fetus remains in utero). Antibiotic prophylaxis has been shown to increase latency to birth but there is limited evidence to guide antibiotic choice to prevent infection in PPROM.

In PROMOAT, pregnant women with PPROM will be randomly assigned to receive one of the three intervention arms:

  • Erythromycin
  • Azithromycin, or
  • Erythromycin and Amoxicillin.

Health outcomes will be assessed using the PLATIPUS Ordinal Outcome Scale, at 42 weeks' postmenstrual age or discharge home, whichever is earliest.

A short questionnaire at Day 7 (or birth, whichever is earlier) will measure compliance and antibiotic tolerance. A maternal and family health questionnaire will be collected at Day 42 postpartum.

Conditions
PPROM, Preterm
Being tested
Erythromycin 250mg + placebo, Azithromycin 500mg + placebo, Erythromycin 250mg and Amoxicillin 500mg
Keywords
Pregnancy, Preterm, PPROM, Antibiotics, chorioamnionitis
Medical subject headings
Preterm Premature Rupture of the Membranes, Premature Birth, Chorioamnionitis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Erythromycin 250mg + placeboDrug

    Antibiotic.

  • Azithromycin 500mg + placeboDrug

    Antibiotic.

  • Erythromycin 250mg and Amoxicillin 500mgDrug

    Antibiotics.

Study groups in NCT06906757
Study groupRoleWhat they receive
Erythromycin 250mg + placeboActive comparatorErythromycin 250mg, four times a day, for 7 days. Oral preparation only. Placebo tablets instead of penicillin for blinding purposes.
Receives: Drug: Erythromycin 250mg + placebo
Azithromycin 500mg + placeboActive comparatorAzithromycin 500mg daily for 7 days. Oral preparation only. Placebo tablets instead of penicillin for blinding purposes.
Receives: Drug: Azithromycin 500mg + placebo
Erythromycin 250mg and Amoxicillin 500mgActive comparatorErythromycin 250mg, four times a day AND Amoxicillin 500mg three times a day, for 7 days. Oral preparations only.
Receives: Drug: Erythromycin 250mg and Amoxicillin 500mg

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of participants who progress by at least one level higher on the PLATIPUS Ordinal Outcome Scale [PLATIPUS Core Primary Outcome]

    The PLATIPUS-Ordinal Outcome Scale ranks the most severe core short-term infant health outcome in the specified time frame.

    Levels 1-15: 1= Well, liveborn infant; 2= Neonatal unit admission for <48 hours; 3= Neonatal unit admission for >/= 48 hours; 4= Non-invasive respiratory support or oxygen therapy for ≥ 4 hours \& < 5 days; 5= Non-invasive respiratory support or oxygen therapy >/= 5 days; 6= Mechanical ventilation via endotracheal tube for ≥ 4 hours \& <7 days; 7= Mechanical ventilation via endotracheal tube for >/=7 days; 8= Moderate respiratory morbidity; 9=Necrotising enterocolitis AND/OR Sepsis; 10= Severe Respiratory Morbidity; 11= Major Surgery; 12= Brain Injury; 13= TWO of severe respiratory morbidity OR major surgery OR brain injury; 14= Severe respiratory morbidity \& major surgery \& brain injury; 15 = Death.

    Measured: At any time prior to 42 weeks' postmenstrual age or first discharge home from hospital (whichever is earlier).]

Secondary outcomes (8)
  1. Time (randomisation) to birth

    Number of days from randomisation to birth.

    Measured: From randomisation to birth

  2. Estimated antepartum/intrapartum/postpartum (< 24 hours) blood loss

    Estimated antepartum/intrapartum/postpartum (<24 hours of birth) blood loss.

    Measured: Less than 24 hours of birth.

  3. Rate of clinical chorioamnionitis

    Clinical chorioamnionitis Clinical suspicion of intra-amniotic infection such as: maternal fever (>/= 38C AND 2 of maternal tachycardia (> 100 beats/min), fetal tachycardia 26,27(> 160 beats/min), uterine tenderness, purulent/malodorous amniotic fluid, maternal leukocytosis (white blood cell count >/= 15,000/mm3) AND Antibiotics commenced for treatment for clinically suspected chorioamnionitis.

    Measured: To birth.

  4. Rate of histological chorioamnionitis/funisitis

    Histological chorioamnionitis/funisitis

    • Presence of inflammation in the placenta, chorion, umbilical cord and/or amnion with or without fetal inflammatory response defined according to staging of maternal (MIR) or fetal inflammatory response (FIR).

    Measured: To birth

  5. Rate of puerperal infection

    Puerperal infection Infection of the maternal genital tract, urinary tract and wound infection from birth to day 42 postpartum AND Antibiotic treatment commenced

    Measured: From birth to day 42 postpartum

  6. Rate of early onset neonatal sepsis

    Isolation of a bacterial or fungal organism from at least one of blood or CSF culture or by PCR sampled within 48 hours of birth AND after consideration of clinical and laboratory evidence, a decision is made to give the infant antibiotics with therapeutic intent against this organism for >5 days

    Measured: Within 48 hours of birth.

  7. Duration of neonatal antibiotic use commenced within 48 hours of birth.

    Duration of neonatal antibiotic treatment commenced within 48 hours of birth.

    Measured: Within 48 hours of birth.

  8. Number of days of maternal antibiotic prescription after birth to day 42 postpartum

    Estimated cumulative days of maternal antibiotic use from birth to day 42 postpartum

    Measured: From birth to Day 42 postpartum

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted2 Apr 2025
  2. Study startSep 2025 (estimated)
  3. Primary completionDec 2029 (estimated)
  4. Study completionDec 2050 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Model description
PROMOAT is a domain within the PLATIPUS adaptive platform trial (NCT06461429).
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
3,900 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06906757
Sponsor's protocol ID
P-P01-PROMOAT
Acronym
PROMOAT
Status last verified
Feb 2025
First submitted
18 Feb 2025
Last updated
2 Apr 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Data sharing will align with PLATIPUS (NCT06461429) policy. Version 1, Apr-2024 Once data unblinding no longer compromises the integrity of the trial, a de-identified data set collected for the analysis of domains within PLATIPUS will be made available. Conditions 1. All domains in which the participant is co-enrolled are closed to recruitment\* (\*Where one or more domains in which a participant is co-enrolled are not yet closed to recruitment, the participant's data may be provided, without the treatment code, to prevent unblinding in unfinished domains). 2. Primary domain conclusions/analyses have been published, AND 3. The 2-year follow-up of participants within the domain/s of interest is/are complete. Supporting materials (Core Protocol, Domain-Specific Appendices, Data Dictionaries and Domain-Specific Statistical Analysis Plans) will be available. Contact: University of Melbourne - info@platipustrial.org.

Questions about this trial

What is this clinical trial studying?

A study testing Erythromycin 250mg and Amoxicillin 500mg in people with PPROM and Preterm, run by University of Melbourne.

The full registered description is in the About this study section and the official record.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 2 Apr 2025. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Clare Whitehead, MBChB, PhD (00610383452000, clarew@unimelb.edu.au), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of participants who progress by at least one level higher on the PLATIPUS Ordinal Outcome Scale [PLATIPUS Core Primary Outcome] (time frame: At any time prior to 42 weeks' postmenstrual age or first discharge home from hospital (whichever is earlier).]). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Apr 2025.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in