Administering antibiotic prior to C-section reduces infection rates by 50 percent

Physicians at the University of Alabama at Birmingham and colleagues have discovered that administering the antibiotic azithromycin alongside the standard recommended antibiotic regimen, cefazolin, reduces infection rates by 50 percent for women who have a non-elective caesarean delivery.

A study shows adding the dose of 500 milligrams of azithromycin during a C-section also significantly decreases the use of health care resources, including readmissions, emergency room visits and clinic visits.

‘Infection during pregnancy and during the post-pregnancy period is a major health problem for both mom and baby, and a common underlying cause of death,’ said Alan T. N. Tita, M.D., Ph.D.; professor in the UAB Division of Maternal-Fetal Medicine and the Center for Women’s Reproductive Health, and principal investigator of the study. ‘Women who have a C-section are at significantly increased risk for infection compared to those who deliver vaginally. A major national goal is to reduce the risk of infection after surgery, and this finding is the culmination of investigative work over decades.’

‘When our group first developed the idea that a second antibiotic could help reduce infections for these women, we found reassurance in the fact that some patients who have preterm premature rupture of the membranes receive two antibiotics to help reduce infection and prolong pregnancy,’ Tita said.

A clinical trial was conducted across 14 hospitals in the United States with 2,013 women who were more than 24 weeks’ gestation and undergoing a C-section during labour or after membrane rupture. A randomized group of patients received either the standard antibiotic regimen to prevent infection or a modified regimen with the additional azithromycin. Pfizer Inc. donated the azithromycin and had no other role in the study.

‘These results are extremely important, given that the maternal death rate has increased in the U.S. and there is an urgent need for therapies to decrease serious complications that can lead to maternal deaths,’ said Uma Reddy, M.D., NICHD project officer for the study.

University of Alabama