A massive international study found that a single course of an inexpensive, generic and long-lasting drug reduced the risk of sepsis in the mother by more than one-third after delivery. Supporters of the study estimate that the drug could prevent 2 million cases of sepsis in mothers each year. A four-pill course of azithromycin, an antibiotic discovered more than 40 years ago, has reduced the risk of maternal sepsis by 35% for mothers in low- and middle-income countries. A previous study in the USA found that IV azithromycin was highly effective in reducing the risk of maternal sepsis in cesarean section patients, halving the rates and is now a recommended practice for cesarean deliveries. A four-pill course of azithromycin, an antibiotic discovered more than 40 years ago, has reduced the risk of maternal sepsis by 35% for mothers in low- and middle-income countries. “This is a huge impact. "If you apply any intervention with an effect size of 35% to such a large human population, the potential is huge," said Julie Gerberding, CEO of the National Institutes of Health Foundation , which supported the study. She told Helen Branswell of STAT. "It's affordable, it's accessible, and we're not talking about a long course of treatment -- we're talking about a dose -- so it's very practical from that perspective," Gerberding said. The trial, called A-PLUS , the New England Journal of Medicine, ended early when independent analysis showed clear benefits for treatment over placebo. what is sepsis? Sepsis is a potentially life-threatening condition in which the immune system overreacts to infection, damaging healthy tissues, sometimes leading to organ failure and even . According to the NIH, this condition is the leading cause of both maternal and neonatal , especially in low-income countries. "We urgently need effective strategies to prevent pregnancy-associated infections, which are responsible for roughly 10% of maternal s worldwide," said Diana W. Bianchi, director of the NIH's Eunice Kennedy Shriver National Institute of Child Health and Human Development . In a statement. NICHD was the primary funder of the study. An intervention that prevents sepsis in mothers may also have indirect benefits for infants. According to Branswell, maternal sepsis increases the risk of infant sepsis, which accounts for 16% of neonatal s worldwide. Study: Starting in 2020, A-PLUS enrolled pregnant women planning a l birth at facilities in Bangladesh, India, Pakistan, Guatemala, Zambia and the Democratic Republic of the Congo. From September 2020 to August 2022, the study randomized 29,278 patients into two groups: one receiving a two-gram oral dose of azithromycin at the time of delivery and the other receiving a placebo. Within six weeks of delivery, 2.3% of patients in the placebo group developed maternal sepsis compared to 1.5% in the azithromycin group. Women who took azithromycin were less likely to develop endometritis and had fewer unscheduled medical visits or return to the hospital than their placebo peers. "We hope our findings will be applied to help improve maternal care in low- and middle-income countries around the world." Alan Tita The researchers who conducted the study believe the good news may actually be even better, the study's lead author Alan Tita told Branswell. Most mothers in South Asian studies were already taking other forms of antibiotics, including those in the placebo group; this could have reduced the risk of sepsis in the mother, underestimating the effect of azithromycin alone. In Africa, azithromycin appeared to have a greater effect, reducing the maternal risk of sepsis or by approximately half, from 3.1% in the placebo group to 1.4% in the treatment group. Conclusion: The authors noted that the experiment has limitations. In addition to pre-existing antibiotic use, rates of unscheduled cesarean sections were higher in non-Africa regions; these factors may have "blunted" the perceived effect of the drug on maternal sepsis. Pre-treating a large group of people with antibiotics could potentially have detrimental effects on the maternal and newborn microbiome and have some impact on the evolution of drug-resistant infections. The study warns that "longer-term data are needed to inform the relationship between the routine use of oral azithromycin prophylaxis for l delivery and its effects on drug resistance and the microbiome." Despite these concerns, the impact of a simple, inexpensive and easy intervention for maternal sepsis can make a big difference in the lives of mothers and children, especially in countries that need it most. "We hope that our findings will be applied to help improve maternal care in low- and middle-income countries around the world," said Tita. We would love to hear from you! If you have a comment on this article or a tip for a future Freethink story, please email us at [email protected]. Gotopnews.com