Azithromycin Cuts Maternal Sepsis, Death in Vaginal Delivery

FRIDAY, Feb. 10, 2023 (HealthDay News) -- For women planning a vaginal delivery, a single dose of azithromycin is associated with a reduction in the risk for maternal sepsis or death, according to a study published online Feb. 9 in the New England Journal of Medicine to coincide with The Pregnancy Meeting, the annual meeting of the Society for Maternal-Fetal Medicine, held from Feb. 6 to 11 in San Francisco.

Alan T.N. Tita, M.D., Ph.D., from the University of Alabama at Birmingham, and colleagues randomly assigned 29,278 women who were in labor at 28 weeks of gestation or more and who were planning a vaginal delivery to receive a single 2-g oral dose of azithromycin or placebo. The data and safety monitoring committee recommended stopping the trial for maternal benefit during an interim analysis.

The researchers found that the incidence of maternal sepsis or death was lower in the azithromycin versus placebo group (1.6 versus 2.4 percent; relative risk, 0.67; 95 percent confidence interval, 0.56 to 0.79; P < 0.001), but the incidence of stillbirth or neonatal death was similar between the groups (10.5 versus 10.3 percent; relative risk, 1.02; 95 percent confidence interval, 0.95 to 1.09; P = 0.56). The incidence of sepsis was the main driver of the difference in the maternal primary outcome (1.5 versus 2.3 percent; relative risk, 0.65; 95 percent confidence interval, 0.55 to 0.77). There was no increase observed in incidence of adverse events with azithromycin.

"Our results are consistent with findings from a large U.S. trial and other studies involving the use of azithromycin in women who had undergone a cesarean delivery and received usual antibiotics," the authors write.

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