News & Commentary

Antibiotics Help Birth Outcomes

François de Brantes minces no words about the shameful state of infant and maternal mortality rates in the United States. De Brantes, a nationally recognized health care expert, reminds us that U.S. infant mortality rates are much worse than such medical backwaters as Antigua and Cuba. “High infant and maternal mortality rates are a completely solvable problem,” de Brantes writes.

And it’s gotten more solvable, apparently. As we were going to press, a study in Lancet grabbed headlines about a simple and effective method for addressing this situation. In the study, published May 13, Oxford University researchers found that prescribing antibiotics as a preventive measure could save about 5,000 new mothers from getting infection in the United States.

They looked at 3,427 mothers who gave medically assisted births between March 13, 2016, and June 13, 2018: 1,719 were treated with amoxicillin and clavulanic acid, and 1,708 were given a placebo. According to the World Health Organization, infection rates after birth without the use of antibiotics are about 16% globally, and that jumps to about 25% when it’s a caesarian section.

The Lancet study found that “women who received a single prophylactic dose of intravenous amoxicillin and clavulanic acid a median of [three hours] after operative vaginal delivery were significantly less likely to have a confirmed or suspected maternal infection than women who received placebo.

Women receiving antibiotic prophylaxis had a 56% reduction in the risk of confirmed systemic infection on culture compared with women receiving placebo.

The women given amoxicillin and clavulanic acid were also significantly less likely to have perineal wound infection, perineal pain, and perineal wound breakdown.

“They were less likely to report any primary care physician or home visits or any hospital outpatient visits in relation to concerns about their perineum compared with the placebo group,” according to the study.

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