zithromax and Mastitis

We have recently completed a proof-of-concept trial showing that bacterial colonization decreased in women and newborns after the administration of azithromycin during labor. Here, we aim to assess the effect of the intervention on maternal and neonatal clinical infections.. This was a double-blind, placebo-controlled randomized trial. Gambian women in labor were given either an oral dose of azithromycin (2 g) or placebo. Follow-up was conducted for 8 weeks after delivery.. From April 2013 to April 2014, we recruited 829 mothers and their 830 newborns. Sixteen infants died during the follow-up period (8 per arm). No maternal deaths or serious adverse events related to the intervention were reported. Maternal infections were lower in the azithromycin group (3.6% vs 9.2%; relative risk [RR], 0.40; 95% confidence interval [CI], 0.22-0.71; P = .002), as was the prevalence of mastitis (1.4% vs 5.1%; RR, 0.29; 95% CI, 0.12-0.70; P = .005) and fever (1.9% vs 5.8%; RR, 0.33; 95% CI, 0.15-0.74; P = .006). Among newborns, the overall prevalence of infections was also lower in the azithromycin group (18.1% vs 23.8%; RR, 0.76; 95% CI, 0.58-0.99; P = .052) and there was a marked difference in prevalence of skin infections (3.1% vs 6.4%; RR, 0.49; 95% CI, 0.25-0.93; P = .034).. Azithromycin given to women in labor decreases infections in both women and newborns during the puerperal period. Larger studies designed to evaluate the effect of the intervention on severe morbidity and mortality are warranted.

Topics: Administration, Oral; Azithromycin; Bacterial Infections; Carrier State; Developing Countries; Double-Blind Method; Female; Fever of Unknown Origin; Gambia; Humans; Infant, Newborn; Infant, Newborn, Diseases; Mastitis; Pneumococcal Infections; Pregnancy; Puerperal Infection; Skin Diseases, Bacterial; Staphylococcal Infections; Staphylococcus aureus; Streptococcal Infections; Streptococcus agalactiae

The efficacy of a newly developed macrolide antibiotic, azithromycin, for infections in the field of surgery, was investigated clinically by means of collaborative studies conducted in 17 major institutes and their affiliated hospitals throughout Japan. The following results were obtained. Clinical assessment: Azithromycin was administered at a dose of 250 mg or 500 mg once a day for 3 days. Clinical efficacy was evaluated in 170 patients. These subjects consisted of 81 with superficial purulent diseases, 12 with mastitis, 25 with periproctal abscess, 42 with superficial secondary infection due to trauma, burn and operative wound, 5 with cholecystitis or cholangitis, and 5 with other infections. The clinical efficacy rate was 96.3% (78/81) for superficial purulent diseases, 83.3% (10/12) for mastitis, 84.0%(21/25) for periproctal abscess, and 76.2%(32/42) for superficial secondary infection due to trauma, burn and operative wound. The overall clinical efficacy rate was 88.8%(151/170) respectively. The bacteriological eradication rate was 87.9%(116/132) for gram-positive bacteria, 85.0%(34/40) for gram-negative bacteria, and 100%(63/63) for anaerobic strains of casual bacteria, which were isolated from 140 patients. The overall bacteriological eradication rate was 90.6%(213/235) respectively. Adverse effects were observed in 6 of 170 patients in whom they were evaluated. They consisted of gastrointestinal symptoms in 5 patients and exanthema in 1. Abnormal changes in clinical laboratory test values were observed in 5 patients, and consisted of eosinophilia in 1, elevations of S-GOT and S-GPT in 1, elevations of S-GOT, S-GPT and gamma-GTP in 1, elevation of S-GPT in 1, and elevations of AL-P and gamma-GTP in 1. These results suggest that azithromycin is very useful for surgical infections in the field of surgery.

Topics: Abscess; Adolescent; Adult; Aged; Anti-Bacterial Agents; Azithromycin; Female; Humans; Male; Mastitis; Middle Aged; Rectal Diseases; Skin Diseases, Infectious; Suppuration; Surgical Wound Infection; Treatment Outcome

3,6-Ketals of 15-membered azalide pseudoaglycones are a novel series of macrolide antibiotics. The aromatic derivatives of the azalide 3,6-ketals demonstrated potent antibacterial activities against both Gram-positive and Gram-negative bacteria.

Topics: Animals; Anti-Bacterial Agents; Azithromycin; Female; Gram-Negative Bacteria; Gram-Positive Bacteria; Mastitis; Mice; Microbial Sensitivity Tests; Staphylococcus aureus; Structure-Activity Relationship