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Complications of cesarean delivery such as endometritis and wound infection lead to significant maternal morbidity and use of health care resources. Given the high annual number of cesareans in the U.S., interventions to lower the postoperative infection rate would have significant impact. Investigators conducted a 14-center randomized trial to determine the effect of adding a single 500-mg intravenous dose of azithromycin (active against ureaplasma and other pathogens) to the standard cefazolin-based perioperative antibiotic regimen for cesareans performed during labor or after membrane rupture.
Of the 1019 women who received adjunctive prophylactic azithromycin, 6.1% had diagnoses of postoperative infection within 6 weeks of delivery compa…