Administering Additional Antibiotic Prior to C-section Reduces Infection Rates by 50 Percent


 
Alan Tita, MD, PhD

Physicians at UAB 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 cesarean delivery.

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

"Infection during pregnancy and during the postpregnancy period is a major health problem for both mom and baby, and a common underlying cause of death," said Alan Tita, MD, PhD, professor in the UAB Division of Maternal-Fetal Medicine and the Center for Women's Reproductive Health. "Women who have a C-section are at significantly increased risk for infection compared to those who deliver vaginally."

A clinical trial funded 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. A randomized group of patients received either the standard antibiotic regimen to prevent infection or a modified regimen with the additional azithromycin.

The UAB Department of Biostatistics analyzed the data to reveal that the frequency of endometritis, an infection of the lining of the uterus, and infection of the cesarean wound were decreased by 50 percent in the women who received the adjunctive azithromycin compared to women who received the standard single antibiotic. The babies who were delivered with the additional azithromycin did not have an increased risk of adverse events.

"There are significant costs associated with infections," Tita said. "The reduction in readmissions, visits, fevers and overall antibiotic use due to the intervention was higher than we expected, and translates to reduced health care costs."

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