A large study involving nearly 30,000 women in low- and middle-income countries found that a single dose of azithromycin given during labor reduced the risk of maternal infection and sepsis. The study was a secondary analysis of a randomized controlled trial, meaning the results are suggestive but not definitive.
Women who received azithromycin had a lower chance of developing an infection compared to those who got a placebo. The benefit was seen both in women who did and did not receive other antibiotics, though the reduction was larger in those not given additional antibiotics. Maternal sepsis rates also appeared lower with azithromycin.
However, the drug did not significantly reduce infections in newborns. The results also varied by region and were not statistically significant when analyzed separately for each site. This means the overall finding may not apply equally everywhere.
Because this is a secondary analysis, the findings should be considered preliminary. More research is needed to confirm the best way to use azithromycin in labor. For now, the study suggests a potential benefit for mothers, but no change in practice is warranted based on this analysis alone.