NDLI: Routine Amoxicillin for Uncomplicated Severe Acute Malnutrition in Children.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Berthé, Fatou Grais, Rebecca F. Gnegne, Smaila Li, Nan Isanaka, Sheila Adehossi, Eric Harouna, Souley Hassane, Hamidine Ousmane, Nassirou Langendorf, Céline Schaefer, Myrto
Description	Author Affiliation: Isanaka S ( From the Department of Research, Epicentre (S.I., C.L., F.B., S.G., R.F.G.), and Médecins sans Frontières Operational Center Paris (M.S.), Paris)
Abstract	BACKGROUND: High-quality evidence supporting a community-based treatment protocol for children with severe acute malnutrition, including routine antibiotic use at admission to a nutritional treatment program, remains limited. In view of the costs and consequences of emerging resistance associated with routine antibiotic use, more evidence is required to support this practice. METHODS: In a double-blind, placebo-controlled trial in Niger, we randomly assigned children who were 6 to 59 months of age and had uncomplicated severe acute malnutrition to receive amoxicillin or placebo for 7 days. The primary outcome was nutritional recovery at or before week 8. RESULTS: A total of 2412 children underwent randomization, and 2399 children were included in the analysis. Nutritional recovery occurred in 65.9% of children in the amoxicillin group (790 of 1199) and in 62.7% of children in the placebo group (752 of 1200). There was no significant difference in the likelihood of nutritional recovery (risk ratio for amoxicillin vs. placebo, 1.05; 95% confidence interval [CI], 0.99 to 1.12; P=0.10). In secondary analyses, amoxicillin decreased the risk of transfer to inpatient care by 14% (26.4% in the amoxicillin group vs. 30.7% in the placebo group; risk ratio, 0.86; 95% CI, 0.76 to 0.98; P=0.02). CONCLUSIONS: We found no benefit of routine antibiotic use with respect to nutritional recovery from uncomplicated severe acute malnutrition in Niger. In regions with adequate infrastructure for surveillance and management of complications, health care facilities could consider eliminating the routine use of antibiotics in protocols for the treatment of uncomplicated severe acute malnutrition. (Funded by Médecins sans Frontières Operational Center Paris; ClinicalTrials.gov number, NCT01613547.).
ISSN	00284793
Issue Number	5
Volume Number	374
e-ISSN	15334406
Journal	New England Journal of Medicine
Language	English
Publisher	Massachusetts Medical Society (United States)
Publisher Date	2016-02-04
Publisher Place	United States
Access Restriction	Subscribed
Subject Keyword	Amoxicillin Therapeutic Use Anti-Bacterial Agents Severe Acute Malnutrition Drug Therapy Bacterial Infections Complications Epidemiology Child, Preschool Double-Blind Method Female Humans Infant Male Nutritional Status Prevalence Physiopathology Treatment Failure Weight Gain Drug Effects Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't Medicine
Content Type	Text
Resource Type	Article
Subject	Medicine

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