In 2023, the Azithromycin Prevention in Labor Use (A-PLUS) trial showed that intrapartum azithromycin reduces maternal sepsis or death in women with planned vaginal delivery in low-resource settings, but whether it reduces maternal infection is unknown.
Melissa Bauserman, MD, MPH, DTM&H, and Jackie Patterson, MD, MPH, performed a post hoc analysis of the multicenter, facility-based, randomized, double-blind, placebo-controlled A-PLUS trial. This trial compared a prophylactic intrapartum single oral dose of 2 g azithromycin versus placebo on maternal morbidity and mortality in low-resource settings in Southeast Asia and Africa from Sept 9, 2020, to Aug 18, 2022.