Azithromycin Prevention in Labor Use Study (A-PLUS)

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Azithromycin Prevention in Labor Use Study (A-PLUS)

Our mission is to protect laboring mothers and newborns against neonatal and maternal sepsis and death

The Azithromycin Prevention in Labor Use Study (A-PLUS) assessed low-cost, sustainable interventions to improve maternal and child health. A-PLUS researchers examined the safety and effectiveness of a single oral dose of intrapartum azithromycin compared to placebo (both in addition to standard of care) in reducing the risk of neonatal and maternal sepsis or death in laboring women. The results were positive, showing that azithromycin reduced the occurrence of sepsis and death by approximately a third.

As a next step, the A-PLUS investigators hope to enable a change to the current standard of care by adding this simple preventive intervention. This large study has great potential to inform and update the World Health Guidelines (WHO) to improve the outcomes of laboring mothers globally.

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Goals

Evaluate the role of a single oral dose of azithromycin (plus usual care) to prevent maternal death or peripartum sepsis and intrapartum/neonatal death or sepsis in laboring women as well as in a targeted sub-population of women at the highest risk for infection (i.e., because they have prolonged labor of ≥ 18 hours, and/or prolonged membrane rupture of ≥ 8 hours).
Study whether a successful prophylaxis intervention significantly reduces the rate of infections and deaths, as well as the need for prolonged antibiotic therapy and associated costs of treating drug-resistant infections.