Background: There is no general accepted strategy for the management of asymptomatic neonates born to mothers with Premature Rupture of Membranes (PROM). Objectives: To compare expectant observation versus prophylactic antibiotics in the management of infections in late preterm infants born to mothers with PROM. Methods: Infants between 34 and 36 weeks gestation weighting ≥1500 grams born to mothers with PROM were randomized to prophylactic antibiotic or expectant observation groups. Primary outcomes were the incidence of bacterial sepsis, and the incidence of systemic bacterial infection during hospitalization. Results: A total of 120 infants were enrolled. No significant difference in sepsis or systemic bacterial infections was found (RR 0.25, 95% CI 0.01 to 5.66, P=0.48; RR 0.80, 95% CI 0.23 to 2.84, P=0.73). The risk of readmission due to infection seemed higher in expectant group, without statistically significant difference (RR 5.10, 95% CI 0.58 to 45.12, P=0.14). Conclusions: Expectant observation strategy could be considered in late preterm infants born to mothers with PROM to reduce unnecessary consumption of antibiotics.