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According to a major clinical trial called A-PLUS, administering a solitary dose of the antibiotic azithromycin orally can lessen the likelihood of postpartum sepsis and mortality by 33% among women who give birth naturally.

Sepsis accounts for 10% of maternal death.

Interestingly, only 1.6% of women who received azithromycin during labour in the study succumbed to sepsis or death within six weeks following delivery. In comparison, 2.4% of those who received a placebo suffered from the same. Azithromycin did not demonstrate any reduction in the probability of stillbirth, newborn sepsis, or newborn death.

The New England Journal of Medicine recently published the results of a study with over 29,000 participants in seven low- and middle-income countries. The study’s findings were also presented at the 43rd Annual Pregnancy Meeting of the Society for Maternal-Fetal Medicine in San Francisco. The trial’s primary funder was the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).

NICHD director Diana Bianchi said that the study findings could potentially change clinical practice by offering a low-cost, safe and effective approach to reducing maternal sepsis and mortality incidence. She added that maternal sepsis accounts for 10% of maternal deaths globally, and there is a need to develop effective prevention strategies.

Azithromycin lowers the incidence of maternal and neonatal sepsis

Maternal and neonatal deaths due to sepsis, a dangerous complication of bacterial and other infections, are prevalent worldwide, particularly in low- and middle-income countries. Azithromycin, an economic antibiotic that works against a wide range of bacteria, is proven to decrease maternal infection after cesarean delivery when administered intravenously. Recent findings from two minor studies indicate that oral administration of azithromycin to women intending to deliver vaginally may lessen the occurrence of maternal or neonatal infection and death.

The study found that administering azithromycin significantly lowered the occurrence of sepsis and endometritis and resulted in fewer hospital readmissions and unplanned healthcare visits. Nevertheless, there was no substantial difference in the rate of stillbirth, newborn sepsis, and death within the first four weeks of life between the azithromycin and placebo groups. In general, 10.5% of births in the azithromycin group and 10.3% in the placebo group experienced adverse effects.