Trial reportAmerican journal of obstetrics and gynecology2015
Perinatal pharmacokinetics of azithromycin for cesarean prophylaxis.
Trial report in American journal of obstetrics and gynecology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 29 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Prevention of Maternal and Neonatal Death/Infections With a Single Oral Dose of Azithromycin in Women in Labor (in Low- and Middle-income Countries): a Randomized Controlled Trial
Azithromycin-based Extended-spectrum Prophylaxis in Scheduled Cesarean Deliveries
Who cites it
29 citing papers in PubMed, 4 syntheses or guidelines pooled it, 65 citations in OpenAlex.
- Effect of humanised care on the surgical site wound infection after caesarean: A meta-analysis.International wound journal · 2024Pooled it
- Effect of adjunctive prophylactic macrolides used at the caesarean section on endometritis and surgical site wound infection: A meta-analysis.International wound journal · 2023Pooled it
- A systematic review on maternal-to-infant transfer of drugs through breast milk during the treatment of malaria, tuberculosis, and neglected tropical diseases.PLoS neglected tropical diseases · 2023Pooled it
- Comparative effectiveness of azithromycin for treating scrub typhus: A PRISMA-compliant systematic review and meta-analysis.Medicine · 2017Pooled it
- Timing of Prophylactic Intrapartum Azithromycin Administration and Efficacy in Prevention of Maternal and Infant Infections: A Secondary Analysis of a Randomized Controlled Trial.BJOG : an international journal of obstetrics and gynaecology · 2026Trial
- Trial
- Timing of Adjunctive Azithromycin for Unscheduled Cesarean Delivery and Postdelivery Infection.Obstetrics and gynecology · 2022Trial
- Pharmacokinetics of Transfer of Azithromycin into the Breast Milk of African Mothers.Antimicrobial agents and chemotherapy · 2015Trial
- Effects of Common Therapies for Threatened Preterm Labor on the Placental Inflammatory Response.American journal of reproductive immunology (New York, N.Y. : 1989) · 2026Article
- Infection-Related Preterm Birth.Maternal-fetal medicine (Wolters Kluwer Health, Inc.) · 2025Review
- The effectiveness of a cesarean delivery bundle with vaginal preparation, cefazolin, and azithromycin in reducing postoperative infections: A before-and-after study.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025Article
- Liquid chromatography-tandem mass spectrometry methods for clinical quantitation of antibiotics.Bioanalysis · 2025Review
- Transporters and drug secretion into human breast milk.Expert opinion on drug metabolism & toxicology · 2025Review
- Successful Transmammary Treatment ofPathogens (Basel, Switzerland) · 2024Article
- Article
- Azithromycin to Prevent Sepsis or Death in Women Planning a Vaginal Birth. Reply.The New England journal of medicine · 2023Article
- Comparing the efficacy in reducing brain injury of different neuroprotective agents following neonatal hypoxia-ischemia in newborn rats: a multi-drug randomized controlled screening trial.Scientific reports · 2023Article
- Maternal antibiotic administration during gestation can affect the memory and brain structure in mouse offspring.Frontiers in cellular neuroscience · 2023Article
- Role of Placental Glucose Transporters in Determining Fetal Growth.Reproductive sciences (Thousand Oaks, Calif.) · 2022Review
- Long term impact of prophylactic antibiotic use before incision versus after cord clamping on children born by caesarean section: longitudinal study of UK electronic health records.BMJ (Clinical research ed.) · 2022Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
objectivePostpartum infections are polymicrobial and typically include Ureaplasma, an intracellular microbe that is treated by macrolides such as azithromycin. The aim of this study was to evaluate the perinatal pharmacokinetics of azithromycin after a single preincision dose before cesarean delivery. STUDY
designThirty women who underwent scheduled cesarean delivery were assigned randomly to receive 500 mg of intravenous azithromycin that was initiated 15, 30, or 60 minutes before incision and infused over 1 hour. Serial maternal plasma samples were drawn from the end of infusion up to 8 hours after the infusion. Samples of amniotic fluid, umbilical cord blood, placenta, myometrium, and adipose tissue were collected intraoperatively. Breast milk samples were collected 12-48 hours after the infusion in 8 women who were breastfeeding. Azithromycin was quantified with high performance liquid chromatography separation coupled with tandem mass spectrometry detection. Plasma pharmacokinetic parameters were estimated with the use of noncompartmental analysis and compartmental modeling and simulations.
resultsThe maximum maternal plasma concentration was reached within 1 hour and exceeded the in vitro minimum inhibitory concentration (MIC50) of 250 ng/mL of Ureaplasma spp in all 30 patients. The concentrations were sustained with a half-life of 6.7 hours. The median concentration of azithromycin in adipose tissue was 102 ng/g, which was below the MIC50. The median concentration in myometrium was 402 ng/g, which exceeded the MIC50. Azithromycin was detectable in both the umbilical cord plasma and amniotic fluid after the single preoperative dose. Azithromycin concentrations in breast milk were high and were sustained up to 48 hours after the single dose. Simulations demonstrated accumulation in breast milk after multiple doses.
conclusionA single dose of azithromycin achieves effective plasma and tissue concentrations and is transported rapidly across the placenta. The tissue concentrations that are achieved in the myometrium exceed the MIC50 for Ureaplasma spp.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.