Sep 18, 2026 · 12 min · 11 segments
Editor's Summary by Linda Brubaker, MD, and Preeti Malani, MD, MSJ, Deputy Editors of JAMA, the Journal of the American Medical Association, for articles published from…
Preeti MalaniHostPostpartum infection remains a major source of maternal morbidity, and cesarean delivery is an important risk factor.
In an original investigation, Dr. Ferreret and colleagues asked whether trial evidence published in 2016 increased perioperative azithromycin for patients undergoing unscheduled cesarean delivery in the United States.
This was a difference-in-difference analysis using Epic Cosmos data from more than 1.6 million deliveries of live-born, singleton infants between 2013 and 2024.
Among cesarean births, perioperative azithromycin use increased from 2.2% before the trial to 39.6% afterward.
Over that same period, postpartum infection after cesarean delivery fell from 9.2% to 8%, an adjusted absolute decrease of 2 percentage points compared with vaginal births, which served as a control group.
This seems like a great example of trial evidence holding up in real-world practice, which is a theme in the accompanying editorial.
The editorialists, Dr. Tita and colleagues, write that this study helps answer the question clinicians always ask after a trial.
Does it work outside the trial setting? The authors note that uptake of adjunctive azithromycin has been incomplete, yet even with less than universal use, the population benefit could still be substantial.
They add that these data strengthen the case for more consistent implementation of adjunctive azithromycin in appropriately selected patients.
Postpartum infection remains a major source of maternal morbidity, and cesarean delivery is an important risk factor.
In an original investigation, Dr. Ferreret and colleagues asked whether trial evidence published in 2016 increased perioperative azithromycin for patients undergoing unscheduled cesarean delivery in the United States.
This was a difference-in-difference analysis using Epic Cosmos data from more than 1.6 million deliveries of live-born, singleton infants between 2013 and 2024.
Among cesarean births, perioperative azithromycin use increased from 2.2% before the trial to 39.6% afterward.
Over that same period, postpartum infection after cesarean delivery fell from 9.2% to 8%, an adjusted absolute decrease of 2 percentage points compared with vaginal births, which served as a control group.
This seems like a great example of trial evidence holding up in real-world practice, which is a theme in the accompanying editorial.
The editorialists, Dr. Tita and colleagues, write that this study helps answer the question clinicians always ask after a trial.
Does it work outside the trial setting? The authors note that uptake of adjunctive azithromycin has been incomplete, yet even with less than universal use, the population benefit could still be substantial.
They add that these data strengthen the case for more consistent implementation of adjunctive azithromycin in appropriately selected patients.
The rest of this transcript — segmented and speaker-labeled, so you land on the exact moment something was said
Search every transcript — by keyword, by phrase, or by meaning, across every show Radar indexes
Trends — what is surging across podcasts, measured against its own baseline
Alerts — when a name you follow appears in a newly indexed episode
No account is needed to search Radar.
