title: A comparative study of azithromycin and sulphadoxine-pyrimethamine as prophylaxis against malaria in pregnancy.
abstract: The benefit of malaria prophylaxis in pregnancy is threatened by emergence of Plasmodium falciparum resistance to antimalarial agents for chemoprophylaxis and treatment.
  
  
  
  This study aimed to compare the effectiveness of azithromycin (AZ) with sulphadoxine-pyrimethamine (SP) for malaria prevention.
  
  
  
  A prospective comparative study of antenatal clinic attendees at the University College Hospital, Ibadan, Nigeria. Participants were randomised to receive SP or AZ.
  
  
  
  The subjects were antenatal attendees and Samples for malaria parasitaemia were collected and repeated at follow-up visits; maternal peripheral blood film, placental and cord blood samples were collected at delivery.
  
  
  
  Chi-square test and t-test in a per-protocol analysis.
  
  
  
  Of 200 participants (100 in each group), 166 (83.0%) completed the study: 86 (86.0%) of SP and 80 (80.0%) of AZ groups, respectively (P = 0.26). Four (4.7%) participants who had SP compared to five (6.2%) in AZ group developed malaria at mean gestational ages of 30.3 ± 1.56 and 33.0 ± 8.6, respectively (P = 0.56). Positive peripheral, placental and cord blood parasitaemia were found in ≤2% of the participants. Drug tolerability and foetal outcomes were comparable for both groups.
  
  
  
  AZ was comparable to SP for prevention of malaria in pregnancy and may be used in patients who do not tolerate SP.
authors.affiliation: Department of Obstetrics and Gynaecology, Adeoyo Maternity Teaching Hospital, Ibadan, Oyo State, Nigeria.
authors.forename: Rukiyat Adeola
authors.initials: RA
authors.lastname: Abdus-Salam
authors.affiliation: Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria.
authors.forename: Folasade Adenike
authors.initials: FA
authors.lastname: Bello
authors.affiliation: Department of Pharmacology and Therapeutics, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria.
authors.forename: Fatai A
authors.initials: FA
authors.lastname: Fehintola
authors.affiliation: Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria.
authors.forename: Ayodele O
authors.initials: AO
authors.lastname: Arowojolu
mesh_terms: D000328:Adult; D017963:Azithromycin / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008288:Malaria / Q000517:prevention & control*; D009549:Nigeria; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control*; D011446:Prospective Studies; D011739:Pyrimethamine / Q000627:therapeutic use*; D013413:Sulfadoxine / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D004338:Drug Combinations; C001205:fanasil, pyrimethamine drug combination; D017963:Azithromycin; D013413:Sulfadoxine; D011739:Pyrimethamine