Study Finds Azithromycin Can Prevent Sepsis During Vaginal Birth

A recent study published in the New England Journal of Medicine determined that a single dose of azithromycin given to pregnant women prior to a planned vaginal birth resulted in lower rates of maternal sepsis or death, but did not affect rates of neonatal sepsis or death.

Key takeaways:

This article will discuss the study findings and provide more information about azithromycin and its use during pregnancy.

Study details

The international study was led by a team of scientists at the University of Virginia Health System. They hypothesized that a single antibiotic dose could decrease the risk of sepsis (a serious bloodstream infection) or death in pregnant women who were planning a vaginal birth, as it does for those undergoing cesarean birth.

The study took place in multiple countries and involved 29,278 women who were in labor at 28 weeks gestation or later and were planning on having a vaginal birth. These women were given a single oral dose of azithromycin or placebo.

The results were remarkable. Maternal sepsis or death was significantly less common in the azithromycin group compared to the placebo group within 6 weeks of delivery. However, the risk of neonatal stillbirth, sepsis, or death within 4 weeks was similar between the two groups.

What is azithromycin?

Azithromycin, also known by the brand name “Zithromax” or “Z-Pac”, is an antibiotic used to treat certain bacterial infections of the ears, lungs, sinuses, skin, throat, and reproductive organs, including sexually transmitted infections.

Azithromycin belongs to a class of medications called macrolide antibiotics. It works by stopping the growth of bacteria.

Azithromycin comes as a tablet or in liquid form to take by mouth.

Benefits of azithromycin

One of the primary benefits of azithromycin is its ability to be used to treat a broad range of bacterial infections. This means there is a good chance that, when used as directed, it will kill whatever harmful bacteria is causing your illness. Another benefit is that azithromycin is considered quite safe to use and is generally well-tolerated in most people.

Risks of azithromycin

Like all medications, taking azithromycin can cause side effects in some people. They are usually mild and not cause for concern, but if you experience side effects that are severe or do not go away, contact your healthcare provider as soon as possible.

Some common side effects of azithromycin include:

  • Nausea
  • Diarrhea
  • Vomiting
  • Stomach pain
  • Headache

Using azithromycin during pregnancy

Azithromycin is considered safe during pregnancy if you have an infection that requires treatment. Most doctors agree that the benefits to both the mother and baby of treating the infection outweigh any potential risks. Azithromycin may be prescribed during pregnancy if you have certain bacterial infections, such as pneumonia, or if you have an STD/STI, such as chlamydia or gonorrhea. It can also treat Lyme disease and severe infections of the sinuses or ears. Recent studies are reassuring that taking azithromycin while pregnant is unlikely to harm the baby.

The prescribed dosage of azithromycin can vary based on the infection being treated. Generally, a healthcare provider will prescribe between 500 and 2000 milligrams once a day as a single dose. Depending on the type of infection, this initial dose may be followed by additional doses of 250 to 500 milligrams once a day for several days. It is important to always take your antibiotic exactly as prescribed by your healthcare provider.

What other antibiotics are safe during pregnancy?

In addition to azithromycin, there are several other types of antibiotics that are considered safe to use during pregnancy. The following groups of antibiotics are generally considered safe:

  • Penicillins, including amoxicillin (Amoxil, Larotid) and ampicillin
  • Cephalosporins, including cefaclor and cephalexin (Keflex)
  • Clindamycin (Coin, Clinda-Derm, Clindagel)

Some antibiotics are more effective at treating certain infections than others. Therefore, it is up to your healthcare provider to decide which antibiotic is the best option for you while also keeping the safety of your unborn child in mind. Always notify your healthcare provider if you are pregnant or breastfeeding prior to starting any new medications, including antibiotics.


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