Study on infections after childbirth wins Research Paper of Year

A study on antibiotics and maternal infections after childbirth has won The BMJ Research Paper of the Year.

The ANODE (prophylactic ANtibiotics for the prevention of infection following Operative DElivery) trial involved 27 UK obstetric units and showed that using a single dose of prophylactic antibiotic after assisted vaginal births (forceps or vacuum extraction) could prevent thousands of infections and reduce antibiotic use.

The BMJ Awards are the UK’s top medical awards programme, recognising and celebrating healthcare teams making a very real difference to patients, every single day, in all sorts of ways.

Senior author Professor Marian Knight from the National Perinatal Epidemiology Unit (NPEU), Nuffield Department of Population Health, University of Oxford, says a “fantastic team effort” by the UK’s “unparalleled” obstetrics research network led to the findings which are being “widely implemented into practice.”

The use of antibiotics during birth by caesarean section is widely recommended. But routine antibiotic prophylaxis has not been recommended for operative vaginal birth because of insufficient evidence of effectiveness.

To address this evidence gap, the trial tracked 1,719 women who received treatment – amoxicillin or clavulanic acid – intravenously and 1,708 who were given a placebo (saline) about three hours after they had given birth.

Six weeks after giving birth, rates of perineal infection, perineal pain, use of pain relief for perineal pain, need for additional perineal care and wound breakdown were statistically significantly lower in the group who received a single dose of antibiotics.

Professor Knight says that almost a fifth of women have an infection, and the results show this can be “reduced by almost half.”

This equates to prevention of over 7,000 infections annually in the UK.

Overall, fewer antibiotics are needed, she adds. “We found that for each additional 100 doses of antibiotic used in prophylaxis, 168 treatment doses will be saved, representing a 17% overall reduction in antibiotic use.”

The results were published in the Lancet.

Dr Fiona Godlee, Editor in Chief at The BMJ said: “This is a great example of how high quality research evidence can have a real and positive impact on patient care and society as a whole, by preventing thousands of infections and reducing antibiotic use. Professor Knight and her team are worthy winners of this year’s award.”

The BMJ Awards has several other healthcare categories. In a change from our usual format, judging and selection of winners in each of these will go ahead virtually, and Dr Fiona Godlee will announce the winners on Wednesday 7 October.

This will be followed by an Awards Showcase video celebrating the 2020 winners and giving greater insight into the winning projects https://thebmjawards.bmj.com/

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