In 2016, the CSOAP trial confirmed that adding Azithromycin 500 mg IV to standard cephalosporin antibiotic prophylaxis pre-Cesarian helps reduce post operative infection. However, mounting evidence supports the addition of iodine-based vaginal prep to pre-CS care. However, no trial yet has compared the Zithromax – cephalosporin regimen to vaginal preparation and cephalosporin prophylaxis. In this podcast, we will summarize the current commentary by Duffy et al from April 2019’s Green Journal on pre-CSection vaginal preparation.