Study of Effectiveness and Safety of Azithromycin-based Extended-spectrum Prophylaxis to Prevent Post Cesarean Infection

Exclusion Criteria

• •Patient unwilling or unable to provide consent
• •Multiple pregnancy
• •Known azithromycin (or other macrolide) allergy
• •Vaginal delivery
• •Elective or scheduled cesarean prior to labor or membrane rupture.
• •Azithromycin, erythromycin or other macrolide antibiotic use within 7 days of enrollment.
• •Clinical chorioamnionitis or any other active bacterial infection (e.g. pyelonephritis, pneumonia, abscess) at time of randomization.
• •Patient is unable or unlikely to follow-up after delivery (e.g. no prenatal care or a non-resident patient)
• •Fetal demise or major congenital anomaly
• •Significant liver disease defined as known cirrhosis or elevated transaminases of at least 3-fold upper limit of normal
• •Significant renal disease defined as serum creatinine known to be \>2.0 mg/dl or on dialysis.
• •Active congestive heart failure (EF\<45%) or pulmonary edema
• •Active diarrhea at time of delivery
• •Any patient with significant electrolyte abnormalities such as hypokalemia or hypocalcemia
• •Any patient with structural heart disease or arrhythmias, or taking any medications known to prolong the QT interval
• •Patient currently being treated with efavirenz, nelfinavir or fluconazole