A Review of the Value of Prophylactic Treatment of Maternal Infections Using Azithromycin in Women Undergoing Planned Vaginal Delivery

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Aim: Puerperal infections are associated with significant maternal as well as neonatal morbidity and mortality. Puerperal sepsis, which results from infection during pregnancy, childbirth, abortion, or after delivery, is a growing problem in underdeveloped and developing countries. Azithromycin is a broad-spectrum antibiotic and its efficacy as an adjunctive prophylaxis in the cesarean section has been established. This review aims to understand the use of azithromycin prophylaxis in women undergoing planned vaginal delivery, and its place in therapy in resource-constrained settings. Methods: The articles were sourced from databases like PubMed, Google Scholar, and websites for health agencies, and the literature search was performed methodically. The selected articles focused on puerperal infections, puerperal sepsis, antibiotic prophylaxis, macrolides, azithromycin, and its safety, and efficacy of azithromycin in puerperal infections, particularly puerperal sepsis. Results: Antibiotics are prescribed in low-resource healthcare settings to overcome the increased risk of puerperal infections as well as the limitations of the healthcare system. Antibiotic prophylaxis involves using broadspectrum antibiotics to prevent infections. Recent studies have demonstrated the efficacy of a single dose of 2g of azithromycin in reducing maternal sepsis or death in women planning vaginal birth. Conclusion: Azithromycin could be an important and economical choice for preventing puerperal sepsis in women undergoing planned vaginal delivery.

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