Evidence map›Paper›PMID 25673788›Full record

Trial reportJournal of clinical microbiology2015

Impact of intermittent preventive treatment in pregnancy with azithromycin-containing regimens on maternal nasopharyngeal carriage and antibiotic sensitivity of Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus: a cross-sectional survey at delivery.

Holger W Unger, Celestine Aho, Maria Ome-Kaius, Regina A Wangnapi, Alexandra J Umbers, Wanda Jack, Alice Lafana, Audrey Michael, Sarah Hanieh, Peter Siba and 3 more

Open access · bronzeAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of clinical microbiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
1.3field-weighted citation impact, top 17% of its field
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 12 citations in OpenAlex.

  1. Trial
  2. Trial
  3. Trial
  4. Oral azithromycin given during labour decreases bacterial carriage in the mothers and their offspring: a double-blind randomized trial.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2016
    Trial
  5. Review
  6. Revisiting Azithromycin for Intermittent Preventive Treatment in Pregnancy.The American journal of tropical medicine and hygiene · 2025
    Article
  7. Article
  8. Article
  9. Article
  10. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 4 institutions in 3 countries.

Holger W UngerDepartment of Medicine (Royal Melbourne Hospital), The University of Melbourne, Parkville, Australia Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea.
Celestine AhoPapua New Guinea Institute of Medical Research, Goroka, Papua New Guinea.
Maria Ome-KaiusPapua New Guinea Institute of Medical Research, Goroka, Papua New Guinea.
Regina A WangnapiPapua New Guinea Institute of Medical Research, Goroka, Papua New Guinea.
Alexandra J UmbersDepartment of Medicine (Royal Melbourne Hospital), The University of Melbourne, Parkville, Australia Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea.
Wanda JackPapua New Guinea Institute of Medical Research, Goroka, Papua New Guinea.
Alice LafanaPapua New Guinea Institute of Medical Research, Goroka, Papua New Guinea.
Audrey MichaelPapua New Guinea Institute of Medical Research, Goroka, Papua New Guinea.
Sarah HaniehDepartment of Medicine (Royal Melbourne Hospital), The University of Melbourne, Parkville, Australia.
Peter SibaPapua New Guinea Institute of Medical Research, Goroka, Papua New Guinea.
Ivo MuellerWalter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia Barcelona Centre for International Health Research (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain Department of Medical Biology, The University of Melbourne, Parkville, Australia.
Andrew R GreenhillPapua New Guinea Institute of Medical Research, Goroka, Papua New Guinea School of Applied and Biomedical Sciences, Federation University, Churchill, Australia.
Stephen J RogersonDepartment of Medicine (Royal Melbourne Hospital), The University of Melbourne, Parkville, Australia sroger@unimelb.edu.au.
Papua New Guinea Institute of Medical Research · PGThe Royal Melbourne Hospital · AUUniversity of Melbourne · AUWalter and Eliza Hall Institute of Medical Research · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Sulfadoxine-pyrimethamine (SP) plus azithromycin (AZ) (SPAZ) has the potential for intermittent preventive treatment of malaria in pregnancy (IPTp), but its use could increase circulation of antibiotic-resistant bacteria associated with severe pediatric infections. We evaluated the effect of monthly SPAZ-IPTp compared to a single course of SP plus chloroquine (SPCQ) on maternal nasopharyngeal carriage and antibiotic susceptibility of Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus at delivery among 854 women participating in a randomized controlled trial in Papua New Guinea. Serotyping was performed, and antibiotic susceptibility was evaluated by disk diffusion and Etest. Potential risk factors for carriage were examined. Nasopharyngeal carriage at delivery of S. pneumoniae (SPAZ, 7.2% [30/418], versus SPCQ, 19.3% [84/436]; P<0.001) and H. influenzae (2.9% [12/418] versus 6.0% [26/436], P=0.028), but not S. aureus, was significantly reduced among women who had received SPAZ-IPTp. The number of macrolide-resistant pneumococcal isolates was small but increased in the SPAZ group (13.3% [4/30], versus SPCQ, 2.2% [2/91]; P=0.033). The proportions of isolates with serotypes covered by the 13-valent pneumococcal conjugate vaccine were similar (SPAZ, 10.3% [3/29], versus SPCQ, 17.6% [16/91]; P=0.352). Although macrolide-resistant isolates were rare, they were more commonly detected in women who had received SPAZ-IPTp, despite the significant reduction of maternal carriage of S. pneumoniae and H. influenzae observed in this group. Future studies on SPAZ-IPTp should evaluate carriage and persistence of macrolide-resistant S. pneumoniae and other pathogenic bacteria in both mothers and infants and assess the clinical significance of their circulation.

Indexed as

AdolescentAdultAntibiotic ProphylaxisAntimalarialsAzithromycinBacterial InfectionsCarrier StateCross-Sectional StudiesDrug CombinationsDrug Resistance, BacterialFemaleHaemophilus influenzaeHumansMalariaMicrobial Sensitivity TestsNasopharynxAntimalarialsAzithromycinDrug Combinationsfanasil, pyrimethamine drug combinationPyrimethamineSulfadoxine

Identifiers

PMID25673788
PMCPMC4365252
OpenAlexW2147285681

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.