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A paper resulting from research into the use of antibiotics to prevent infection after operative vaginal birth has been named BMJ UK Research Paper of the Year 2020.

The research led by Professor Marian Knight, from the National Perinatal Epidemiology Unit, Nuffield Department of Population Health, found that using a single dose of antibiotic to prevent infections after assisted vaginal births would reduce antibiotic use by 17% and halve the rate of infection.

The use of antibiotics during birth by caesarean section is widely recommended but World Health Organization and national guidelines, recognising the importance of antibiotic stewardship, did not recommend routine antibiotic prophylaxis for operative vaginal birth.

The ANODE (prophylactic ANtibiotics for the prevention of infection following Operative DElivery) trial, funded by the National Institute for Health Research, investigated whether a single dose of antibiotic prevented maternal infection after operative vaginal birth. The trial showed a clear benefit of a single dose of prophylactic antibiotic.

Senior author, Professor Marian Knight, said ‘Almost one in five women experience an infection after operative vaginal birth. Our paper demonstrated that this could be reduced by almost half with routine use of antibiotic prophylaxis. This equates to prevention of over 7,000 infections annually in the UK. Guidance has now changed to recommend that all women who have an assisted vaginal birth should receive this preventive antibiotic dose.

‘I am delighted that the importance of this work has been recognised through the BMJ UK Research Paper of the Year 2020 award. The award is testament to the hard work of everyone in the ANODE Collaborative Group who contributed to this research.’

The BMJ Awards aim to ‘promote excellence in healthcare, showcase knowledge and experience that will inspire others, and give exposure to teams who demonstrate courage and passion for overcoming challenges in our common mission to improve outcomes for patients and communities across the country’.

The UK Research Paper of the Year award is one of two Special Recognition Awards. It recognises original UK research that has the potential to contribute significantly to improving health and healthcare. The paper, Prophylactic antibiotics in the prevention of infection after operative vaginal delivery (ANODE): a multicentre randomised controlled trial, was selected from amongst all UK research projects published over the last year.  

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 awards ceremony has been postponed this year to support global efforts to contain the spread of COVID-19. The winners of other BMJ Awards will be announced in October.

Read more on The BMJ website and listen to an interview with Professor Marian Knight.