Common antibiotic may be cost-saving treatment for reducing maternal sepsis: Study

Giving an oral dose of antibiotic azithromycin to pregnant people may be a cost-saving treatment for reducing maternal sepsis, death or infection in developing countries, according to a study that used data from seven countries, including India.

Sepsis, a severe infection that can lead to tissue damage, organ failure, and death, is one of the top three causes of maternal deaths worldwide, according to the World Health Organization.

The life-threatening emergency is largely preventable with early diagnosis and treatment and disproportionately affects pregnant people in low- and middle-income countries (LMICs).

Previous research has found that administering a single oral dose of azithromycin to everyone in labour significantly reduced the risk of maternal sepsis or death in seven low- and middle-income countries.

The latest study, published in the American Journal of Obstetrics and Gynecology, examined the costs versus benefits of using this intervention in India, Pakistan, Bangladesh, the Democratic Republic of the Congo, Guatemala, Kenya, and Zambia.

Using data from the Azithromycin Prevention in Labor Use (A-Plus) trial, the researchers looked at the cost of giving the antibiotic to everyone in labour compared to the health care costs associated with treatment for people with sepsis and infection.

Results demonstrated that azithromycin is a low-cost intervention for preventing sepsis and the reduction in health care use, such as fewer hospital admissions and clinic visits, results in cost savings.

“Sepsis remains a leading cause of maternal death globally, and the burden is greatest in low-resource settings,” said the study’s lead author Jackie Patterson, an associate professor at the University of North Carolina in the US.

“Ministries of health have to weigh the various interventions at their disposal and decide how to best allocate the limited resources they have. It’s a big deal to have an effective therapy for maternal sepsis that is also cost-saving to implement in a low-resource setting,” Patterson said.

For every one lakh pregnancies, an oral dose of azithromycin prevented 1,592 cases of maternal sepsis, death or infection and 249 maternal hospitalisations.

The cost of administering the antibiotic was 91 cents per pregnancy. The overall analysis demonstrated a cost-savings of USD 32,661 per one lakh pregnancies, the researchers said.