Effect of Antibiotics on Short-Term Growth among Children in Burkina Faso: A Randomized Trial

Abstract

Antibiotics improve both weight and height gain in randomized trials of preschool children with preexisting morbidity. Here, we assess the effect of a short course of three different antibiotics (amoxicillin, azithromycin, and cotrimoxazole) on short-term linear and ponderal growth in a population-based sample of preschool children in rural Burkina Faso. We randomized households with at least two children in the Nouna district, Burkina Faso, to a 5-day course of amoxicillin, azithromycin, cotrimoxazole, or placebo. Within each antibiotic-randomized household, one child was randomly assigned to receive the antibiotic and the other to receive the placebo. Weight and height measurements were taken at baseline and 30 days following the last study medication dose. Weight-for-height (WHZ), height-for-age (HAZ), and weight-for-age (WAZ) scoreswere calculated based on the 2006 World Health Organization standards. Of the 124 households and 248 children enrolled, 229 had anthropometry measurements at 1 month and were analyzed. Children randomized to amoxicillin gained significantly more weight compared with both the placebo household (mean difference 317 g, 95% confidence interval [CI]: 115-519 g) and placebo sibling (mean difference 315 g, 95% CI: 147-482 g) controls. Growth velocity in g/kg/day, and WHZ and WAZ scores were higher in amoxicillin-treated children compared with placebo households and siblings. There were no differences in weight gain in children randomized to azithromycin or cotrimoxazole compared with placebo households or placebo siblings. There were no differences in height gain or HAZ across any of the study arms. Amoxicillin may have short-term growth-promoting effects in healthy children.

Indirect effect of oral azithromycin on the gut resistome of untreated children: a randomized controlled trial

“…Of these 58 children, >95% of their cohabiting siblings finished their respective treatment course. 12 Approximately two-thirds of enrolled children were female and the median age was 20 months (Table 1 ). Resistance genetic determinants to multiple classes of antibiotics were common in the gut, particularly tetracyclines, trimethoprim and beta-lactams (Table 2 ).…”

Short-term weight gain among preschool children in rural Burkina Faso: a secondary analysis of a randomised controlled trial

“…For the trial, 165 households were assessed for eligibility and 41 were excluded because two children were not present in the household. The remaining 124 households were eligible for inclusion and were enrolled in the study 11. A total of 248 children were enrolled in the study, of whom 233 had eligible anthropometric measurements at baseline and 4 weeks after treatment.…”

“…All treatments were directly observed by study staff and administered as paediatric oral suspension. Children were followed for 35 days from enrolment for anthropometric outcomes 11. All data were collected and managed in CommCare (Dimagi, Cambridge, Massachusetts, USA).…”

Indirect Effect of Azithromycin Use on the Intestinal Microbiome Diversity of Untreated Children: A Randomized Trial

“…We conducted a randomized controlled trial in 2 rural communities of the Nouna Health and Demographic Surveillance System [ 9 ]. Detailed methods for the study have been reported elsewhere [ 2 , 10 ]. The study took place in July 2017, at the beginning of the annual rainy season.…”