Azithromycin at birth: Single dose azithromycin shortly before birth - what is the impact on infection rates in high-risk mothers and babies? A randomised controlled trial

Infections after childbirth — including wound infections, mastitis, and uterine infections — are a significant cause of illness in new mothers and their babies, particularly in high-risk groups. Azithromycin is an antibiotic that has been shown to reduce post-operative infections when given as a single pre-operative dose in some surgical contexts. This trial asks whether a single dose given just before birth can reduce post-birth infection rates in at-risk mothers and newborns. Pregnant women who are Aboriginal and/or Torres Strait Islander, or non-Indigenous women having early (27–36 weeks) or operative births, will be randomly assigned to receive either a single dose of azithromycin or a placebo shortly before delivery. Both mothers and babies will be followed up for 6 weeks to track infection rates and antibiotic use. You may be eligible if you are 16 or older, pregnant, giving birth at Royal Darwin Hospital, and are either Aboriginal or Torres Strait Islander, or are having a preterm or operative birth. Women who have already received azithromycin in the past 7 days, have an allergy to azithromycin, are at less than 26 weeks gestation, or have been diagnosed with chorioamnionitis are not eligible.