Antibiotic Treatment for Maternal Sepsis Found to Reduce Healthcare Costs Significantly

CHAPEL HILL, NC – A groundbreaking international study has revealed that the widespread use of azithromycin, an effective antibiotic, in combating maternal sepsis can lead to substantial reductions in healthcare costs. The research, led by experts from the UNC School of Medicine and the Kinshasa School of Public Health, demonstrates the economic benefits of this intervention, particularly in low- and middle-income countries.

Maternal sepsis, a life-threatening condition arising from bacterial infections during pregnancy or childbirth, is a leading cause of maternal mortality and a major financial burden on healthcare systems globally. The condition often necessitates costly hospitalizations and intensive treatments.

The study, recently published in The Lancet Global Health, analyzed data from the Azithromycin Prevention in Labor Use Study (A-PLUS trial), which involved 29,278 pregnant women across eight countries, including the Democratic Republic of Congo (DRC), Kenya, Zambia, Bangladesh, India, Pakistan, and Guatemala. The initial A-PLUS trial, published in the New England Journal of Medicine, showed that a 2-gram dose of azithromycin during labor reduced the risk of maternal sepsis or death by 33% in women delivering vaginally.

The cost-effectiveness analysis revealed that while implementing intrapartum azithromycin costs approximately $0.91 per woman planning a vaginal birth, it also averts healthcare costs associated with sepsis, saving health systems $1.24 per woman. This translates to a net saving of $0.33 per pregnancy.

“Whenever we find a therapy that’s effective, policymakers need to understand the costs, particularly in settings where resources are limited,” said Dr. Jackie Patterson, lead author of the study and associate professor of pediatrics at the UNC School of Medicine. “Studies that look at cost-effectiveness are really important to influence policy, and, in our case, we showed that health systems can actually save money by implementing this intervention.”

On a larger scale, the study found that the use of intrapartum azithromycin resulted in a net saving of $32,661 per 100,000 pregnancies. This significant reduction in healthcare expenditure highlights the potential for azithromycin to be a cost-effective preventative measure against maternal sepsis.

“This is a big deal because most health care interventions increase health care costs,” Patterson added. “We showed that using an effective intervention like azithromycin actually reduces health care costs because now these women do not need to go to a clinic or get admitted to the hospital to get treatment for sepsis.”

The findings are expected to influence global healthcare policies, particularly in low- and middle-income countries, where maternal sepsis poses a significant threat. The study also underscores the relevance of this research to high-income countries, including the United States, which also faces challenges with maternal mortality and sepsis.

Disclaimer: This article is based on the provided research and should not be taken as medical advice. Always consult with a healthcare professional for any medical concerns or before making any decisions related to your health or treatment.¹ The information provided reflects the findings of the study and may not represent the views of all medical experts. Results may vary depending on individual circumstances and healthcare systems.(

More information: Jackie K Patterson et al, Cost-effectiveness of intrapartum azithromycin to prevent maternal infection, sepsis, or death in low-income and middle-income countries: a modelling analysis of data from a randomised, multicentre, placebo-controlled trial, The Lancet Global Health (2025). DOI: 10.1016/S2214-109X(24)00517-5. www.thelancet.com/journals/lan … (24)00517-5/fulltext