A common antibiotic has been found to reduce low birth weight and premature births, if taken during pregnancy, in countries where malaria is endemic, according to a research review, led by the Murdoch Children’s Research Institute (MCRI). The study found that the antibiotic, azithromycin, reduced low birth weight and prematurity in Africa and Asia but didn’t lower infant deaths, infections and hospital admissions.
The researchers reviewed 14 studies undertaken in African and Asian countries, involving 17,594 participants. Azithromycin is an inexpensive antibiotic widely used to treat chest and ear infections. In pregnancy, it has been specifically used in the past to treat STIs and, alongside other antimalarial drugs, to prevent adverse consequences of malaria on maternal and fetal outcomes and caesarean wound infections. MCRI researcher Dr Maeve Hume-Nixon said it was unclear whether azithromycin would improve perinatal and neonatal outcomes in non-malaria endemic settings, and the potential harm on stillbirth rates needed further investigation. The Bulabula MaPei study is a randomized controlled clinical trial testing if azithromycin given to women in labor, prevents maternal and infant infections. Globally, infections cause about 21 per cent of 2.4 million neonatal deaths each year and 52 per cent of all under five deaths, with a disproportionate amount occurring in low- and middle-income countries. Infections are also common in mothers with about five million cases of pregnancy-related infections occurring each year, resulting in 75,000 maternal deaths. MCRI Professor Fiona Russell said the large clinical trials in Africa and Asia, along with the MCRI-led trial in Fiji, were likely to inform global policy related to maternal child health and hopefully benefit infants and mothers around the world. Researchers from the University of Melbourne and The Royal Children’s Hospital also contributed to the review.