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Dr. Kim Boggess, a professor in the Division of Maternal-Fetal Medicine, and her team have discovered that administering azithromycin prior to cesarean delivery reduces infection by half.


Dr. Kim Boggess, a professor in the Division of Maternal-Fetal Medicine at UNC OB-GYN, and fellow investigators of the Cesarean Section Optimal Antibiotic Prophylaxis (C/SOAP) study have discovered that administering the antibiotic, azithromycin alongside the standard recommended antibiotic regimen, cefazolin, reduces infection rates by 50 percent for women who have a non-elective cesarean delivery. Adding the dose of 500 milligrams of azithromycin during a C-section also significantly decreases the use of health care resources, including readmissions, emergency room visits, and clinic visits.

The collaborators, which span 14 hospitals across the United States and were led by the University of Alabama at Birmingham, detail their findings in the current issue of the New England Journal of Medicine.

“The risk of infection during pregnancy is among the top five causes of maternal death in the United States,” said Boggess. “It is an important, but understudied problem.”

“Women who have a C-section are at a significantly increased risk of infection compared to those who deliver vaginally,” said Alan T. N. Tita, M.D.,Ph.D.; professor in the UAB Division of Maternal-Fetal Medicine and the Center for Women’s Reproductive Health, and principal investigator of the study. “A major national goal is to reduce the risk of infection after surgery and this finding is the culmination of investigative work over decades.”

Cesarean delivery is the most common major surgical procedure, with up to five times the risk for infection than a vaginal delivery.

“There are significant costs associated with infections,” Tita said. “The reduction in readmissions, visits, fevers and overall antibiotic use due to the intervention was higher than we expected, and translate to reduced health care costs.”

This story was developed in conjunction with the University of Alabama at Birmingham. Read the entire release at the UNC Center for Women’s Health Research.