08 Mar Effect of Antibiotics During Pregnancy on Neonatal Sepsis and Mortality
MedicalResearch.com Interview with:
Dr. Roca
Anna Roca PhD
MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine
Fajara, The Gambia
MedicalResearch.com: What is the background for this study?
Response: Context specific interventions are needed to decrease the high burden of severe neonatal morbidity and mortality in sub-Saharan Africa. Severe bacterial infections are a main cause of neonatal mortality in the continent. Oral intra-partum azithromycin is a cheap intervention easily scalable. Before embarking on this trial, we conducted a proof-of-concept trial that showed the intervention reduced maternal and neonatal bacterial carriage of the most prevalent bacteria causing neonatal sepsis in the continent.
MedicalResearch.com: What are the main findings?
Response: The main findings are the intra-partum azithromycin does not reduce neonatal sepsis and mortality. However, the intervention reduces maternal (such as mastitis or any infections) and neonatal (such as skin infections or any infections) infections, maternal and neonatal fever, and the need for prescribed antibiotics in the neonates. The intervention seems to reduce bacterial confirmed sepsis, a small percentage of all neonatal sepsis.
MedicalResearch.com: What should readers take away from your report?
Response: Our results do not support the use of intra-partum azithromycin to reduce neonatal sepsis or mortality but the use for other endpoints should be considered balancing the risk of increasing antibiotic resistance.
MedicalResearch.com: What recommendations do you have for future research as a results of this study?
Response: As the intervention reduced infections and likely bacterial confirmed sepsis, but it did not reduce overall neonatal sepsis, it may be that overall sepsis and bacteriologically confirmed sepsis as well as neonatal infections are caused by different pathogens and further research on this is necessary.
Citation:
Roca A, Camara B, Bognini JD, et al. Effect of Intrapartum Azithromycin vs Placebo on Neonatal Sepsis and Death: A Randomized Clinical Trial. JAMA. 2023;329(9):716–724. doi:10.1001/jama.2022.24388
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