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Intrapartum azithromycin prophylaxis reduced maternal infections but showed no effect on neonatal sepsis and mortality. Although antibiotic exposure may indirectly alter the mycobiota (community of fungi that live in a given environment), there is no data available on how intrapartum azithromycin impacts gut mycobiota development. We hereby assess the impact of intrapartum azithromycin on gut mycobiota development from birth to the age of three years, by ITS2 gene profiling of rectal samples from 102 healthy Gambian infants selected from a double-blind randomized placebo-controlled clinical trial (PregnAnZI-2 - ClinicalTrials.org NCT03199547). In the trial, women received 2 g oral azithromycin or placebo (1:1) during labour with the intension of assessing effect on neonatal sepsis or mortality. Secondary objectives included effects on bacterial carriage and resistance, puerperal infections, and infant growth. Our analysis show that season and parity were key factors that influenced gut mycobiota development. Intrapartum azithromycin increased the abundance of Candida orthopsilosis but only in the wet season and did not show different effects by sex of the child. These data suggest that season and parity can be key factors influencing gut mycobiota development and may inform strategies for a wider implementation of intrapartum azithromycin intervention.
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http://dx.doi.org/10.1038/s41467-025-62142-w | DOI Listing |
Sci Rep
August 2025
Department of Medical Laboratory Science, College of Medicine and Health Sciences, Raya University, Maichew, Ethiopia.
Group B Streptococcus (GBS) is a normal constituent of the female genital and gastrointestinal flora but remains a leading cause of perinatal bacterial infections, including endometritis, bacteremia, chorioamnionitis, and urinary tract infections in pregnant women. In Ethiopia, reported GBS colonization rates among pregnant women range from 7.2 to 25.
View Article and Find Full Text PDFIntrapartum azithromycin prophylaxis reduced maternal infections but showed no effect on neonatal sepsis and mortality. Although antibiotic exposure may indirectly alter the mycobiota (community of fungi that live in a given environment), there is no data available on how intrapartum azithromycin impacts gut mycobiota development. We hereby assess the impact of intrapartum azithromycin on gut mycobiota development from birth to the age of three years, by ITS2 gene profiling of rectal samples from 102 healthy Gambian infants selected from a double-blind randomized placebo-controlled clinical trial (PregnAnZI-2 - ClinicalTrials.
View Article and Find Full Text PDFJ Obstet Gynaecol Can
July 2025
Department of Obstetrics and Gynecology, Galilee Medical Center, Nahariya, Israel; Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel.
Objectives: Antibiotic prophylaxis in preterm pre-labour rupture of membranes (PPROM) is associated with a reduced rate of clinical chorioamnionitis. In recent randomized controlled trials, cefuroxime combined with a macrolide was more effective than traditional ampicillin-based regimens in prolonging latency and reducing gram-negative neonatal infections. Accordingly, our institution revised its PPROM prophylactic antibiotic protocol from ampicillin and roxithromycin to cefuroxime and azithromycin.
View Article and Find Full Text PDFBMC Med
April 2025
Department of Paediatrics, The University of Melbourne, Melbourne, Australia.
Background: Prophylactic azithromycin in pregnancy has been shown to lower infections in birthing parents and newborns, particularly skin and soft tissue infections (SSTIs) which are common in Fiji. We aimed to determine the safety and efficacy of 2 g of oral azithromycin administered during labour on infant SSTIs.
Methods: This blinded, randomised placebo-control trial included healthy, pregnant adults and their infants presenting for delivery at a tertiary hospital in Suva, Fiji.
Lancet Glob Health
April 2025
Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA.
Background: In 2023, the Azithromycin Prevention in Labor Use (A-PLUS) trial showed intrapartum azithromycin reduces maternal sepsis or death in women with planned vaginal delivery in low-resource settings, but whether it reduces maternal infection is unknown. We aimed to evaluate the effectiveness of intrapartum azithromycin in reducing maternal infection.
Methods: We performed a post-hoc analysis of the multicentre, facility-based, randomised, double-blind, placebo-controlled A-PLUS trial.