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A COMPARISON OF ANTIBIOTIC REGIMENS IN THE TREATMENT OF PRETERM PREMATURE RUPTURE OF MEMBRANES. Introduction: Rupture of amniotic membranes before labor that occurs before 37 weeks of gestation is referred to as ?Preterm Prelabor Rupture Of Membranes? (PPROM). To reduce maternal and neonatal infections during expectant management of women with PPROM, the substitution of azithromycin for erythromycin is a suitable alternative antibiotic regimen secondary to its ease of administration, better side effect profile, and decreased cost. Aims & Objectives: The goal of this study is to see if there is a difference between the antibiotic (azithromycin) compared to the antibiotic (erythromycin) in prolonging pregnancy in patients and the development of chorioamnionitis with Preterm Premature Rupture of Membranes (PPROM). Materials and Methods : The study was carried out in the Department of Obstetrics and Gynecology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow after getting ethical clearance from the Institute?s Ethical Committee. It will be a single-center, prospective observational cohort study. Pregnant women between 24 0/7 to 36 0/7 weeks of gestation presenting with PPROM were included in the study. The Erythromycin group consisted of erythromycin 250 mg and ampicillin 2 g every 6 hours IV for 48 hours followed by amoxicillin 250 mg and erythromycin 333 mg every 8 hours PO for 5 days (7 Days total). The azithromycin group consisted of azithromycin 1 g PO once. Patients were followed till delivery. Results : 394 patients who met inclusion criteria were identified. 197 study participants received an erythromycin-based antibiotic regimen in the first half of the study and the remaining 197 received an Azithromycin-based regimen in the second half of the study. There was no statistical difference in the primary outcome of latency to delivery. Unadjusted median time from PPROM to delivery was 9 days for the azithromycin group and 7 days for erythromycin (P = .98). The clinical rates of chorioamnionitis was seen in 50 pregnant women of Group 1 and 33 pregnant women of Group2 and this difference was statistically significant (p value=0.04). Conclusion: Patients with PROM who are treated with azithromycin have similar latency periods but lower rates of clinical chorioamnionitis when compared to those treated with erythromycin. We speculate this may be due to azithromycin?s longer half-life, higher tissue concentration, and increased activity against enteric pathogens such as E. coli. Azithromycin could be considered as an alternative to erythromycin in the expectant management of Preterm Premature Rupture Of Membranes if erythromycin is unavailable or contraindicated.