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HealthQuiet 8d · day 10

Real-world data show azithromycin cuts cesarean infections by 20%

Use of the antibiotic jumped from 2% to 40% after a 2016 trial, and postpartum infection rates fell sharply.

newest coverage 7d agosummary written 7d ago6 pieces NewswiresGoogle News

What to know

  • Azithromycin use in unscheduled cesarean deliveries surged from 2% to 40% following a 2016 trial showing it cuts infections by 50%—real-world data now confirm the practice works, reducing postpartum infections by an estimated 20%.
  • At 300,000+ unscheduled cesareans annually in the U.S., a 20% infection reduction could prevent roughly 6,000 cases each year, addressing a significant source of preventable maternal morbidity.
  • ACOG guidelines currently call for azithromycin to be 'considered'; experts argue the evidence now justifies upgrading to 'recommended use,' though universal implementation remains incomplete.

“Future work should refine patient selection and monitor the effects on maternal mortality and global antimicrobial resistance. The current evidence indicates that failure to implement this strategy represents a missed opportunity to reduce preventable maternal morbidity and potentially mortality.”

Alan Tita, MD, PhD, and colleagues, Editorial authors · MedPage Today ↗ · Sep 13

Taylor Freret, MD Maternal-fetal medicine physician, lead authorAlan Tita, MD, PhD Lead investigator of C/SOAP trial; editorialistAaron Caughey, MD, PhD Ob/Gyn professor, independent commenterAmerican College of Obstetricians and Gynecologists (ACOG) Professional guideline body

Real-world data show azithromycin cuts cesarean infections by 20%
MedPage Today

How it unfolded 3 developments, newest first · click a bar or a number to jump articles

Peak 2 pieces in 3h at Sep 14, 2 PM; 6 pieces over 10 days (6 articles) Sep 14, 11 AM — 1 piece · 1 article — Newswires 1Sep 14, 2 PM — 2 pieces · 2 articles — Google News 2Sep 14, 5 PM — quietSep 14, 8 PM — quietSep 14, 11 PM — quietSep 15, 2 AM — quietSep 15, 5 AM — quietSep 15, 8 AM — quietSep 15, 11 AM — 2 pieces · 2 articles — Google News 2Sep 15, 2 PM — quietSep 15, 5 PM — quietSep 15, 8 PM — quietSep 15, 11 PM — quietSep 16, 2 AM — quietSep 16, 5 AM — 1 piece · 1 article — Newswires 1Sep 16, 8 AM — quietSep 16, 11 AM — quietSep 16, 2 PM — quietSep 16, 5 PM — quietSep 16, 8 PM — quietSep 16, 11 PM — quietSep 17, 2 AM — quietSep 17, 5 AM — quietSep 17, 8 AM — quietSep 17, 11 AM — quietSep 17, 2 PM — quietSep 17, 5 PM — quietSep 17, 8 PM — quietSep 17, 11 PM — quietSep 18, 2 AM — quietSep 18, 5 AM — quietSep 18, 8 AM — quietSep 18, 11 AM — quietSep 18, 2 PM — quietSep 18, 5 PM — quietSep 18, 8 PM — quietSep 18, 11 PM — quietSep 19, 2 AM — quietSep 19, 5 AM — quietSep 19, 8 AM — quietSep 19, 11 AM — quietSep 19, 2 PM — quietSep 19, 5 PM — quietSep 19, 8 PM — quietSep 19, 11 PM — quietSep 20, 2 AM — quietSep 20, 5 AM — quietSep 20, 8 AM — quietSep 20, 11 AM — quietSep 20, 2 PM — quietSep 20, 5 PM — quietSep 20, 8 PM — quietSep 20, 11 PM — quietSep 21, 2 AM — quietSep 21, 5 AM — quietSep 21, 8 AM — quietSep 21, 11 AM — quietSep 21, 2 PM — quietSep 21, 5 PM — quietSep 21, 8 PM — quietSep 21, 11 PM — quietSep 22, 2 AM — quietSep 22, 5 AM — quietSep 22, 8 AM — quietSep 22, 11 AM — quietSep 22, 2 PM — quietSep 22, 5 PM — quietSep 22, 8 PM — quietSep 22, 11 PM — quietYesterday, 2 AM — quietYesterday, 5 AM — quietYesterday, 8 AM — quietYesterday, 11 AM — quietYesterday, 2 PM — quietYesterday, 5 PM — quietYesterday, 8 PM — quietYesterday, 11 PM — quietToday, 2 AM — quietToday, 5 AM — quiet ◂ 1 earlier23
Sep 15Sep 16Sep 17Sep 18Sep 19Sep 20Sep 21Sep 22now · 6:44 AM ET
  1. 3

    Experts acknowledge adoption as evidence-based practice but note gaps in universal implementation

    Aaron Caughey from Oregon Health & Science University characterized the shift as 'a pretty clear demonstration of adoption of an evidence-based change in practice,' while Taylor Freret noted the drug is becoming standard practice but has not yet reached universal implementation despite the evidence.

    “It's really becoming more standard clinical practice, but I would say it's not quite at the level of it being recommended, and that every single person is getting it.”
    — Taylor Freret, MD
  2. 2

    Editorial calls for stronger ACOG guideline backing azithromycin use

    Alan Tita and colleagues, including Tita who led the original C/SOAP trial, published an accompanying editorial arguing the real-world evidence strengthens the case for moving ACOG guidelines from 'consideration' to 'recommended use' in unscheduled, high-risk cesarean deliveries, noting that failure to implement represents a missed opportunity to reduce preventable maternal morbidity and mortality.

    “These data strengthen the case for more consistent implementation of adjunctive azithromycin in appropriately selected patients and support a move in the ACOG guidelines from 'consideration' to 'recommended use' in unscheduled, high-risk cesarean deliveries.”
    — Alan Tita, MD, PhD
    1. 1 outlet Real-World U.S. Data Back Azithromycin After Unscheduled C-Sections

      first by MedPage Today, 9d ago

  3. 1

    Analysis of 1.6 million births shows azithromycin use jumped to 40%, infections fell to 8%

    Researchers at Beth Israel Deaconess Medical Center analyzed data from the Epic Cosmos database spanning 2013–2024, finding azithromycin use in cesarean deliveries rose from 2.2% to 39.6%, while postpartum infection rates within 6 weeks fell from 9.2% to 8%—a 20% relative reduction. This translates to potentially preventing 6,000 infections annually.

    “Given that more than 300,000 individuals have an unscheduled cesarean delivery annually, a 20% reduction, if due to the use of azithromycin, would still represent a meaningful improvement in postpartum outcomes, potentially preventing 6,000 infections each year.”
    — Taylor Freret, MD
  4. background

    ACOG updates guidelines to 'consider' azithromycin for unscheduled cesareans — The American College of Obstetricians and Gynecologists updated its guidelines following the C/SOAP trial results, recommending that azithromycin be 'considered' in unscheduled cesarean deliveries.

  5. background

    C/SOAP trial shows azithromycin cuts cesarean infections by 50% — The Cesarean Section Optimal Antibiotic Prophylaxis (C/SOAP) trial published results showing that adding azithromycin to standard antibiotic prophylaxis in unscheduled cesarean deliveries reduced postoperative infections by nearly 50%.

Also covered reported alongside — the timeline has no entry for these yet

  1. 2 outlets Emergency C-section infections decline as azithromycin use rises following previous clinical trial results

    first by medicalxpress.com, 8d ago · also Medscape

    1 more headline

and 3 smaller pieces