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The Making of Medicine

Common Antibiotic Can Save Lives of Moms During Delivery

The antibiotic azithromycin, also known as "Z-Pak," can protect mothers from dangerous sepsis infections and death during vaginal childbirth, a new study reveals.

The antibiotic is already being given to women delivering by caesarian section in the United States and elsewhere, but the new findings suggest that azithromycin will benefit women delivering vaginally as well. And that could have a big impact around the world.

“The simplicity of this intervention should allow its institution around the globe to protect mothers during childbirth,” noted researcher William A. Petri Jr., MD, PhD, who is part of our Division of Infectious Diseases and International Health.

Infections, particularly sepsis, are among the top causes of maternal mortality worldwide. They are responsible for approximately 10% of maternal deaths shortly before, during and after childbirth.

The new results come from the Azithromycin Prophylaxis in Labor Use Study (A-PLUS) Trial Group, an international team of researchers that examined the antibiotic's benefits in more than 29,000 women in low- and middle-income countries. Half of the trial participants -- all volunteers -- were given azithromycin, while the other half received a placebo.

Of the 14,526 women who received the antibiotic, only 1.6% had developed sepsis or died within six weeks. That's compared with 2.4% of the 14,637 women who received the harmless placebo. The difference was so significant that the trial was ended early.

Unfortunately, the same benefit was not seen for the women's babies. But the benefits for the moms, combined with an absence of harmful side effects, identify azithromycin as an important tool for improving childbirth outcomes around the world.

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