While results were statistically nonsignificant, risk of infection trended down for
Women in labor and/or with rupture of membranes for ≥4 hours
RR 0.88 (95% CI, 0.56 to 1.39)
Adjusted RR 0.82 (95% CI, 0.52 to 1.30)
Women with clinical chorioamnionitis
RR 0.37 (95% CI, 0.08 to 1.67)
Data too sparse for adjusted analysis
In the subgroup of women who were not in labor, the after cohort had a nonsignificant increased risk of the composite outcome
RR 1.53 (95% CI, 0.86 to 2.72)
Adjusted RR 1.48 (95% CI, 0.83 to 2.65)
Adding azithromycin to preoperative prophylaxis for all cesarean deliveries trended towards reduced infections, but results did not reach significance
If there is a beneficial effect, it appears to be smaller in the real world vs previous studies
The authors state
Given these results, we have decided that our extrapolation of azithromycin administration to nonlaboring women during cesarean deliveries does not seem to be helpful, and we have discontinued this practice
We are continuing to add azithromycin for cesarean delivery in women who are laboring and/or have rupture of membranes and in women with chorioamnionitis
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