Azithromycin Use Rose, Postpartum Infections Fell After Cesarean Trial

A difference-in-differences analysis using Epic Cosmos data from over 1.6 million US deliveries (2013-2024) examined adoption of adjunctive azithromycin during unscheduled cesarean delivery following 2016 trial evidence. The study reported azithromycin use during cesarean births rose from 2.2% before 2016 to 39.6% after, with an adjusted difference-in-differences increase of 37.6 percentage points versus vaginal births. Postpartum infection after cesarean delivery fell from 9.2% to 8.0% over the same period, corresponding to an adjusted difference-in-differences decrease of 2.0 percentage points.

Most relevant for: Pregnant individuals undergoing unscheduled cesarean delivery and clinicians managing intrapartum and postpartum care in that setting.

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