Efficacy of Extended Antibiotic Prophylaxis with Azithromycin in Cesarean Sections

Background: Surgical site infections (SSIs) are a serious concern in cesarean sections, leading to research on improved preventive measures, to evaluate the effectiveness of standard antibiotic prophylaxis alone versus an extended regimen that includes azithromycin in reducing SSIs in nonelective cesarean sections. Methods: In this randomized controlled trial, 288 women who were undergoing nonelective cesarean sections at a tertiary care hospital in South India were involved. Participants were divided into two groups: one receiving standard prophylaxis with cefazolin and the other receiving an extended regimen with azithromycin. The main focus was on the occurrence of SSIs within six weeks after the surgery. Results: The extended regimen group had a slightly lower incidence of SSIs (1.42%) compared to the standard regimen group (6.12%), but this difference did not reach statistical significance (P = 0.112). Conclusion: Although the inclusion of azithromycin alongside standard prophylactic antibiotics demonstrated a slight decrease in SSIs, the results did not reach statistical significance. These findings indicate potential advantages in certain patient groups, which should be explored in more detail.