Purpose: There is debatable data regarding the addition of azithromycin to the routine antibiotic prophylaxis of post-cesarean section (CS)
infection. In this work, we tried to evaluate its potential benefit to protect against both post-cesarean maternal and fetalinfections.
Methods: The study included 230 women who were intended to have
selective CS at Mansoura university hospital. They were randomly
subdivided into115 women that received azithromycin plus standard
cephalosporin and another115 women that received standard cephalosporin alone. The main outcome is evaluation of post-cesarean section
infection as endometritis, wound sepsis, etc… across the puerperal period.
Results: In comparison between the test group and the control group,
there was significant reduction of re-admission during puerperium(0%
vs 6.5%, p=0.01). Endometritis manifestations were significantly reduced, including: puerperal Fever >38OC (4.3% versus 15.2%), uterine tenderness (3.2% versus 11.9%), abdominal pain (1.1% versus
14.1%), offensive vaginal discharge (2.1% versus 13%) and purulent
drainage from uterus (2.1% versus 9.8%). Wound infection manifestations were significantly reduced, including; erythema around incision
(2.1%versus 8.7), induration around incision (3.2 versus 12%) and purulent discharge from incision site (1.1% versus 9.8%). Also, the need
for further antibiotic during puerperium was significantly reduced
(3.2% versus 11.9%). There was no significant difference between the
2 groups regarding neonatal outcomes.
Conclusion: Azithromycin plus the standard cephalosporin administered to women in selective CS reduces maternal infections and maternal episodes of fever, with no clear benefit on the neonatal outcome