Single-dose antibiotic can prevent maternal sepsis and death (1 dose Azithromycin = 33% less sepsis in mothers)

Medical Xpress / NIH / Eunice Kennedy Shriver National Institute / New England Journal of Medicine ^ | Feb. 9, 2023 | Alan T.N. Tita et al

[ConservativeMind]

A single oral dose of the antibiotic azithromycin can reduce the risk of postpartum sepsis and death among women who deliver vaginally by one-third, according to a large multi-country clinical trial, called A-PLUS. Only 1.6% of women in the study who received azithromycin during labor developed sepsis or died within six weeks after delivery, compared to 2.4% of those who received placebo. Azithromycin did not reduce the risk of stillbirth, newborn sepsis or newborn death.

Sepsis—a life-threatening complication of bacterial and other infections—is a leading cause of maternal and newborn deaths worldwide, especially in low- and middle-income countries. Azithromycin, an inexpensive antibiotic effective against a broad range of bacteria, is known to reduce maternal infection when given intravenously during cesarean delivery. Two small studies have suggested that giving the oral version of the drug to women who plan to deliver vaginally may reduce maternal or neonatal infection and death.

29,278 participants planning to deliver vaginally were randomly assigned to receive either a two-gram dose of oral azithromycin or a placebo during labor.

Within the first six weeks after delivery, 227 of 14,526 participants (1.6%) who received azithromycin developed sepsis or died, compared to 344 of 14,637 (2.4%) in the placebo group. Deaths were rare in both groups. Sepsis occurred in 219 participants in the azithromycin group (1.5%) and 339 in the placebo group (2.3%). Additionally, women who received azithromycin were less likely to develop endometritis (infection of the lining of the womb) and other infections. They also had fewer hospital readmissions and unscheduled healthcare visits, compared to the placebo group.

Stillbirth, newborn sepsis or death within the first four weeks of life occurred with comparable frequencies in azithromycin and placebo groups. Overall, these adverse events occurred for 10.5% of births in the azithromycin group and 10.3% in the placebo group.

[ConservativeMind]

Readily available antibiotic stops sepsis, but it is a larger dose than we’d normally use (two grams).

[ConservativeMind]

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[nickcarraway]

I think they mean septicemia. The definition of sepsis was completely changed.

[trebb]

Too cheap and available - next up, a “new and better solution with only 87 potentially fatal side effects - ask your OBGYN if it’s right for you.”