Azithromycin Prophylaxis for PRElabor CEsarean DElivery Trial

NCT ID: NCT06605118

Last Updated: 2025-04-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

RECRUITING

Clinical Phase

PHASE3

Total Enrollment

8000 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-11-04

Study Completion Date

2028-03-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

This is a phase-III multi-center double-blind randomized controlled trial of 8,000 individuals undergoing a scheduled or prelabor cesarean delivery who are randomized to either adjunctive azithromycin prophylaxis or to placebo. Both groups also will receive standard of care preoperative antibiotics (excluding azithromycin). The primary endpoint is a maternal infection composite defined as any one of the following up to 6 weeks postpartum: endometritis, wound infection, abscess, septic thrombosis, sepsis, pneumonia, pyelonephritis and breast infection.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

This is a phase-III multi-center double-blind randomized controlled trial of 8,000 individuals undergoing a scheduled or prelabor cesarean delivery who are randomized to either azithromycin prophylaxis or to placebo. All participants will receive standard of care preoperative antibiotics. The primary objective is to evaluate in patients undergoing scheduled/prelabor cesarean if pre-incision adjunctive azithromycin prophylaxis reduces the risk of post-cesarean infections compared with placebo. Secondary objectives include 1) to assess the perinatal and maternal safety of pre-incision adjunctive azithromycin, 2) to evaluate whether adjunctive azithromycin prophylaxis reduces maternal and neonatal resource use outcomes compared with placebo, and 3) to evaluate whether adjunctive azithromycin influences maternal and neonatal infection with resistant organisms compared with placebo.

Individuals will be randomized prior to the start of the cesarean to either 500mg of intravenous azithromycin or to placebo (normal saline). Maternal blood and cord blood will be collected on a subset of the population. Research staff will abstract maternal and neonatal outcomes following delivery and discharge from the hospital. A single maternal follow-up study visit at 6 weeks (4-8 weeks) postpartum will be scheduled to ascertain maternal and neonatal outcomes.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Obstetrical Complications Labor and Delivery Complication Cesarean Delivery

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Participants will be randomized shortly before delivery to receive either azithromycin administered intravenously or a placebo control of normal saline administered intravenously
Primary Study Purpose

PREVENTION

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors
The study medication will be prepared by the center research pharmacies from a list provided by the independent data coordinating center, with the active and placebo medication having identical appearance. No other individuals, including the participant or any other clinical or research staff will be informed of the study assignment.

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Azithromycin prophylaxis and standard of care preoperative antibiotics

500mg of intravenous azithromycin administered up to 1 hour prior to cesarean incision (or as soon as feasible after incision) and infused over one hour per FDA infusion recommendations for azithromycin. Additionally patients will received standard of care preoperative antibiotics (excluding azithromycin) prior to incision.

Group Type EXPERIMENTAL

Azithromycin Injection

Intervention Type DRUG

500mg azithromycin in 250 mL of normal saline

Standard of Care Preoperative antibiotics

Intervention Type DRUG

standard of care preoperative antibiotics (excluding azithromycin) prior to incision

Placebo and standard of care preoperative antibiotics

Normal saline administered up to 1 hour prior to cesarean incision (or as soon as feasible after incision) and infused over one hour in addition to standard of care preoperative antibiotics (excluding azithromycin) prior to incision.

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

250 mL of normal saline

Standard of Care Preoperative antibiotics

Intervention Type DRUG

standard of care preoperative antibiotics (excluding azithromycin) prior to incision

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Azithromycin Injection

500mg azithromycin in 250 mL of normal saline

Intervention Type DRUG

Placebo

250 mL of normal saline

Intervention Type DRUG

Standard of Care Preoperative antibiotics

standard of care preoperative antibiotics (excluding azithromycin) prior to incision

Intervention Type DRUG

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* ≥ 23 weeks' gestation (ACOG dating criteria)
* Scheduled or prelabor cesarean delivery
* Singleton or twin gestation

Exclusion Criteria

* Allergy or contraindication to azithromycin or macrolide antibiotics, including those with a history of cholestatic jaundice/hepatic dysfunction associated with prior use of azithromycin
* Chorioamnionitis
* Bacterial infection (e.g., pyelonephritis) requiring ongoing antibiotic treatment after delivery
* Premature rupture of membranes (PROM) or labor (i.e., contractions with ongoing cervical change)
* Fetal demise or known major congenital anomaly
* Azithromycin treatment within 7 days
* Planned use of antimicrobial prophylaxis after delivery for any reason
* Known structural heart disease or active cardiomyopathy (current ejection fraction\<40%)
* Known arrhythmia with QT prolongation or taking scheduled medications known to prolong the QT interval such that it would preclude the use of azithromycin
* Refusal or unable to obtain consent (e.g., language barrier)
* Participating in another intervention study that influences the primary outcome in this study
* Participation in this trial in a previous pregnancy. Patients who were screened in a previous pregnancy, but not randomized, do not have to be excluded.
Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

NIH

Sponsor Role collaborator

University of Alabama at Birmingham

OTHER

Sponsor Role collaborator

The George Washington University Biostatistics Center

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Alan T.N. Tita, MD PhD

Role: STUDY_CHAIR

University of Alabama at Birmingham

Kim Boggess, MD

Role: STUDY_CHAIR

University of North Carolina, Chapel Hill

Monica Longo, MD PhD

Role: STUDY_DIRECTOR

Eunice Kennedy Shriver NICHD

Rebecca G Clifton, PhD

Role: PRINCIPAL_INVESTIGATOR

The George Washington University Biostatistics Center

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

University of Alabama - Birmingham

Birmingham, Alabama, United States

Site Status RECRUITING

Regents of the University of California San Francisco

San Francisco, California, United States

Site Status RECRUITING

Northwestern University

Chicago, Illinois, United States

Site Status RECRUITING

Columbia University

New York, New York, United States

Site Status RECRUITING

University of North Carolina - Chapel Hill

Chapel Hill, North Carolina, United States

Site Status RECRUITING

Duke University

Durham, North Carolina, United States

Site Status RECRUITING

Case Western Reserve University

Cleveland, Ohio, United States

Site Status RECRUITING

Ohio State University

Columbus, Ohio, United States

Site Status RECRUITING

Hospital of the University of Pennsylvania

Philadelphia, Pennsylvania, United States

Site Status RECRUITING

Magee Women's Hospital

Pittsburgh, Pennsylvania, United States

Site Status RECRUITING

Brown Univeristy

Providence, Rhode Island, United States

Site Status RECRUITING

Baylor College of Medicine

Houston, Texas, United States

Site Status RECRUITING

University of Texas - Houston

Houston, Texas, United States

Site Status RECRUITING

University of Utah

Salt Lake City, Utah, United States

Site Status RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

United States

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Rebecca G Clifton, PhD

Role: CONTACT

301-881-9260

Steven Weiner, MS

Role: CONTACT

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Donna Dunn, PhD, CNM, FNP-BC

Role: primary

205.996.6268

Natalie Oman, MPH

Role: primary

206-718-4703

Elizabeth Rangel, RN

Role: primary

Megan Loffredo, MD, CCRC

Role: primary

203-722-1058

Kelly Clark, RN

Role: primary

919-350-6117

Jennifer Ferrara, RNC MSN

Role: primary

919-681-6176

Abigail Pierse, BS

Role: primary

216-778-8443

Anna Bartholomew, RN, BSN

Role: primary

614-685-3229

Christina Pizzi, BSN, RN, CBC

Role: primary

267-273-8574

Jeanette Boyce, RN

Role: primary

412-527-8118

Angelica DeMartino, RN, BSN

Role: primary

401-274-1122 ext. 48521

Christina Reed, RN, NP

Role: primary

832-826-7377

Jia Chen, RN, CCRP

Role: backup

713-798-3798

Felecia Ortiz, RN

Role: primary

713-500-6467

Amber Sowles, RN

Role: primary

801-585-5499

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

U01HD114634

Identifier Type: NIH

Identifier Source: secondary_id

View Link

U24HD036801

Identifier Type: NIH

Identifier Source: secondary_id

View Link

HD036801-PRECEDE

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Vitality in Infants Via Azithromycin for Neonates Trial
NCT05763693 NOT_YET_RECRUITING PHASE4