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News

Antibiotics as part of the management of severe acute malnutrition

A study in this week's issue of the New England Journal of Medicine investigates antibiotics as part of the management of severe acute malnutrition.

News image

Severe acute malnutrition contributes to 1 million deaths among children annually.

Adding routine antibiotic agents to nutritional therapy may increase recovery rates, and decrease mortality among children with severe acute malnutrition treated in the community.

Dr Indi Trehan and colleagues performed a randomized, double-blind, placebo-controlled trial of children, 6 to 59 months of age, with severe acute malnutrition to receive amoxicillin, cefdinir, or placebo for 7 days in addition to ready-to-use therapeutic food for the outpatient treatment of uncomplicated severe acute malnutrition.

The primary outcomes were the rate of nutritional recovery and the mortality rate.

The team enrolled a total of 2767 children with severe acute malnutrition.

In the amoxicillin groups, 89% of the children recovered
New England Journal of Medicine

In the amoxicillin, cefdinir, and placebo groups, 89%, 91%, and 85% of the children recovered.

The research team reported that the mortality rates for the 3 groups were 5%, 4%, and 7%, respectively.

Among children who recovered, the rate of weight gain was increased among those who received antibiotics.

The dotors reported no interaction between type of severe acute malnutrition, and intervention group was observed for either the rate of nutritional recovery or the mortality rate.

Dr Trehan's team concluded, "The addition of antibiotics to therapeutic regimens for uncomplicated severe acute malnutrition was associated with a significant improvement in recovery and mortality rates."

N Engl J Med 2013; 368:425-435
05 February 2013

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