Randomized controlled trial investigating the efficacy of oral azithromycin in preventing perinatal infections in pregnant women undergoing labor induction.
Huimin Cao, Yan Zhou, Ning Gu et al.
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In 30 seconds
This single-center randomized controlled trial assessed whether oral azithromycin reduces infection in 472 women with term singleton pregnancies undergoing labor induction. Participants received 2 g of azithromycin or no additional treatment. Overall perinatal infection occurred in 16.1% versus 16.9%, respectively (absolute risk difference −0.85%; RR 0.950, 95% CI 0.633–1.425; P = 0.804), with no significant difference. Neonatal infectious disease and other reported maternal and neonatal outcomes were also comparable. The authors concluded that azithromycin added no benefit in this setting, where antibiotic prophylaxis was already intensive.
Key findings
- Overall perinatal infection was 16.1% with azithromycin and 16.9% with no additional treatment (RR 0.950, 95% CI 0.633–1.425; P = 0.804).
- Neonatal infectious diseases occurred in 2.5% versus 5.1%, respectively (P = 0.149).
- Gastrointestinal symptoms were reported by 3.4% (8/236) of azithromycin recipients; the total adverse event rate was 3.8% (9/236).
Why it matters
The trial found no measurable reduction in perinatal infection from adding oral azithromycin for women undergoing term labor induction in a setting with intensive antibiotic prophylaxis. This helps clarify that an additional antibiotic dose may not improve outcomes under these conditions, while also documenting adverse events. The findings are specific to the population and care setting studied.
What to keep in mind
The trial was single-center, and its conclusion applies to a well-resourced setting with intensive antibiotic prophylaxis; the abstract does not establish effects in other settings.