Adjunctive Azithromycin Prophylaxis for Prelabor Cesarean Birth.

Area of Science:

• Obstetrics and Gynecology
• Infectious Diseases
• Surgical Prophylaxis

Background:

• Cesarean births are associated with significant maternal morbidity due to postoperative infections.
• Standard antibiotic prophylaxis aims to reduce these infection rates, but further improvements are sought.

Purpose of the Study:

• To evaluate the impact of adding azithromycin to standard antibiotic prophylaxis on maternal postoperative infections in prelabor cesarean births.

Main Methods:

• A retrospective cohort study compared infection rates before and after the addition of intravenous azithromycin to standard prophylaxis.
• The study included singleton gestations undergoing prelabor cesarean birth at a tertiary care center.
• Outcomes were analyzed using multivariable analysis and propensity score matching.

Main Results:

• Adjunctive azithromycin was associated with significantly lower odds of composite postpartum infection (3.3% vs. 4.8%).
• Reductions were observed in wound infections, wound seroma, and wound dehiscence.
• No significant differences in neonatal morbidities were noted between the groups.

Conclusions:

• The addition of azithromycin to standard antibiotic prophylaxis for prelabor cesarean deliveries is associated with a reduction in maternal postpartum infections.
• This strategy represents a potential improvement in surgical site infection prevention for cesarean births.