Effect of intrapartum azithromycin on early childhood gut mycobiota development: post hoc analysis of a double-blind randomized trial

Abstract Intrapartum azithromycin prophylaxis reduced maternal infections but showed no effect on neonatal sepsis and mortality. Although antibiotic exposure may indirectly alter the mycobiota (community of fungi that live in a given environment), there is no data available on how intrapartum azithr...

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Main Authors: Bakary Sanyang, Magdalena B. Dabrowska, Nelly Amenyogbe, Bully Camara, Nathalie Beloum, Mariama Jammeh, Dodou Bojang, Jack Goodall, Nuredin Mohammed, Abdul Karim Sesay, Anna Roca, Thushan I. de Silva
Format: Article
Language:English
Published: Nature Portfolio 2025-08-01
Series:Nature Communications
Online Access:https://doi.org/10.1038/s41467-025-62142-w
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author Bakary Sanyang
Magdalena B. Dabrowska
Nelly Amenyogbe
Bully Camara
Nathalie Beloum
Mariama Jammeh
Dodou Bojang
Jack Goodall
Nuredin Mohammed
Abdul Karim Sesay
Anna Roca
Thushan I. de Silva
author_facet Bakary Sanyang
Magdalena B. Dabrowska
Nelly Amenyogbe
Bully Camara
Nathalie Beloum
Mariama Jammeh
Dodou Bojang
Jack Goodall
Nuredin Mohammed
Abdul Karim Sesay
Anna Roca
Thushan I. de Silva
author_sort Bakary Sanyang
collection DOAJ
description Abstract Intrapartum azithromycin prophylaxis reduced maternal infections but showed no effect on neonatal sepsis and mortality. Although antibiotic exposure may indirectly alter the mycobiota (community of fungi that live in a given environment), there is no data available on how intrapartum azithromycin impacts gut mycobiota development. We hereby assess the impact of intrapartum azithromycin on gut mycobiota development from birth to the age of three years, by ITS2 gene profiling of rectal samples from 102 healthy Gambian infants selected from a double-blind randomized placebo-controlled clinical trial (PregnAnZI-2 – ClinicalTrials.org NCT03199547). In the trial, women received 2 g oral azithromycin or placebo (1:1) during labour with the intension of assessing effect on neonatal sepsis or mortality. Secondary objectives included effects on bacterial carriage and resistance, puerperal infections, and infant growth. Our analysis show that season and parity were key factors that influenced gut mycobiota development. Intrapartum azithromycin increased the abundance of Candida orthopsilosis but only in the wet season and did not show different effects by sex of the child. These data suggest that season and parity can be key factors influencing gut mycobiota development and may inform strategies for a wider implementation of intrapartum azithromycin intervention.
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spelling doaj-art-4144499e00264ad7950eab54b9e2d4ca2025-08-20T03:05:10ZengNature PortfolioNature Communications2041-17232025-08-0116111310.1038/s41467-025-62142-wEffect of intrapartum azithromycin on early childhood gut mycobiota development: post hoc analysis of a double-blind randomized trialBakary Sanyang0Magdalena B. Dabrowska1Nelly Amenyogbe2Bully Camara3Nathalie Beloum4Mariama Jammeh5Dodou Bojang6Jack Goodall7Nuredin Mohammed8Abdul Karim Sesay9Anna Roca10Thushan I. de Silva11Medical Research Council Unit The Gambia at The London School of Hygiene and Tropical MedicineDivision of Clinical Medicine, School of Medicine and Population Health, The University of SheffieldDepartment of Microbiology and Immunology, Canadian Centre for Vaccinology, Dalhousie UniversityMedical Research Council Unit The Gambia at The London School of Hygiene and Tropical MedicineMedical Research Council Unit The Gambia at The London School of Hygiene and Tropical MedicineMedical Research Council Unit The Gambia at The London School of Hygiene and Tropical MedicineMedical Research Council Unit The Gambia at The London School of Hygiene and Tropical MedicineDivision of Clinical Medicine, School of Medicine and Population Health, The University of SheffieldMedical Research Council Unit The Gambia at The London School of Hygiene and Tropical MedicineMedical Research Council Unit The Gambia at The London School of Hygiene and Tropical MedicineMedical Research Council Unit The Gambia at The London School of Hygiene and Tropical MedicineMedical Research Council Unit The Gambia at The London School of Hygiene and Tropical MedicineAbstract Intrapartum azithromycin prophylaxis reduced maternal infections but showed no effect on neonatal sepsis and mortality. Although antibiotic exposure may indirectly alter the mycobiota (community of fungi that live in a given environment), there is no data available on how intrapartum azithromycin impacts gut mycobiota development. We hereby assess the impact of intrapartum azithromycin on gut mycobiota development from birth to the age of three years, by ITS2 gene profiling of rectal samples from 102 healthy Gambian infants selected from a double-blind randomized placebo-controlled clinical trial (PregnAnZI-2 – ClinicalTrials.org NCT03199547). In the trial, women received 2 g oral azithromycin or placebo (1:1) during labour with the intension of assessing effect on neonatal sepsis or mortality. Secondary objectives included effects on bacterial carriage and resistance, puerperal infections, and infant growth. Our analysis show that season and parity were key factors that influenced gut mycobiota development. Intrapartum azithromycin increased the abundance of Candida orthopsilosis but only in the wet season and did not show different effects by sex of the child. These data suggest that season and parity can be key factors influencing gut mycobiota development and may inform strategies for a wider implementation of intrapartum azithromycin intervention.https://doi.org/10.1038/s41467-025-62142-w
spellingShingle Bakary Sanyang
Magdalena B. Dabrowska
Nelly Amenyogbe
Bully Camara
Nathalie Beloum
Mariama Jammeh
Dodou Bojang
Jack Goodall
Nuredin Mohammed
Abdul Karim Sesay
Anna Roca
Thushan I. de Silva
Effect of intrapartum azithromycin on early childhood gut mycobiota development: post hoc analysis of a double-blind randomized trial
Nature Communications
title Effect of intrapartum azithromycin on early childhood gut mycobiota development: post hoc analysis of a double-blind randomized trial
title_full Effect of intrapartum azithromycin on early childhood gut mycobiota development: post hoc analysis of a double-blind randomized trial
title_fullStr Effect of intrapartum azithromycin on early childhood gut mycobiota development: post hoc analysis of a double-blind randomized trial
title_full_unstemmed Effect of intrapartum azithromycin on early childhood gut mycobiota development: post hoc analysis of a double-blind randomized trial
title_short Effect of intrapartum azithromycin on early childhood gut mycobiota development: post hoc analysis of a double-blind randomized trial
title_sort effect of intrapartum azithromycin on early childhood gut mycobiota development post hoc analysis of a double blind randomized trial
url https://doi.org/10.1038/s41467-025-62142-w
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