A single dose of the antibiotic azithromycin can help protect mothers from dangerous sepsis infections and death during vaginal childbirth, a new international study has found.
Azithromycin, also known as Z-Pak, has already been shown to benefit women delivering by cesarean section. But the new findings reveal that the common antibiotic reduces mortality for women delivering vaginally and cuts their risk of developing sepsis, a potentially fatal full-body infection.
Infections, particularly sepsis, are responsible for 10% of maternal deaths shortly before, during and after childbirth, putting such infections in the top five causes of maternal mortality worldwide.
“A single dose of the antibiotic azithromycin decreased sepsis and death by half in women in labour,” said researcher William A. Petri Jr., MD, PhD, of the University of Virginia School of Medicine’s Division of Infectious Diseases and International Health. “The simplicity of this intervention should allow its institution around the globe to protect mothers during childbirth.”
Petri is part of the Azithromycin Prophylaxis in Labour Use Study (A-PLUS) Trial Group, an international coalition of researchers that set out to determine if giving the antibiotic during childbirth would benefit either mothers or their children. More than 29,000 women in low- and middle-income countries volunteered to take part in the randomised trial; half were given azithromycin and half were given a harmless placebo.
Among the 14,637 women who received the placebo, 2.4% developed sepsis or died within six weeks; that’s compared with only 1.6% of the 14,526 women who received azithromycin. The difference was clear enough that the researchers stopped the trial early.
The antibiotic did not provide similar benefits for the babies, the researchers found. However, they say that benefits for the mothers, combined with the lack of harmful side effects, makes azithromycin an important new tool for keeping moms safe before, during and after delivery. (The antibiotic is already recommended for caesarian births in the United States and elsewhere.)
The researchers have published their findings in the New England Journal of Medicine. A full list of the authors and their affiliations is included in the paper.
The research was supported by The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and the Foundation for the National Institutes of Health through the Maternal, Newborn & Child Health Discovery & Tools initiative of the Bill and Melinda Gates Foundation.
