Effect of intrapartum azithromycin on gut microbiota development in early childhood: A post hoc analysis of a...

Area of Science:

• Microbiology
• Neonatal Health
• Public Health

Background:

• Intrapartum azithromycin prophylaxis can reduce maternal infections but does not impact neonatal sepsis or mortality.
• Early-life antibiotic exposure may negatively affect gut microbiota development and lead to adverse health outcomes.

Purpose of the Study:

• To assess the impact of 2g oral intrapartum azithromycin on gut microbiota development in infants from birth to 3 years.
• To investigate potential long-term consequences of early-life antibiotic exposure on the infant gut microbiome.

Main Methods:

• Analysis of rectal samples from 127 healthy infants in the PregnAnZI-2 double-blind randomized placebo-controlled trial.
• 16S-rRNA gene profiling was used to characterize gut microbiota composition and trajectories.
• Comparison of microbiota development between azithromycin and placebo groups during the first month of life.

Main Results:

• Infants receiving intrapartum azithromycin exhibited slower gut microbiota community transition in the first month.
• Significant increase in Enterobacteriaceae (p=0.001) and a decrease in Bifidobacterium (p<0.001) were observed in the azithromycin group.
• A trend towards increased Enterococcaceae (p=0.064) was noted in infants exposed to azithromycin.

Conclusions:

• Intrapartum azithromycin significantly alters infant gut microbiota development during the crucial first month of life.
• The observed increase in proinflammatory bacteria and decrease in beneficial Bifidobacterium may have undesirable long-term health effects.
• Further research is warranted to understand the full implications of these early-life microbiome alterations.