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Antibiotics Improve Outcomes in Treatment of Malnutrition

Recovery up, mortality down for malnourished children receiving antibiotics plus nutritional tx

THURSDAY, Jan. 31 (HealthDay News) -- For the treatment of severe, acute malnutrition in children, the addition of antibiotics to nutritional therapeutic regimens improves rates of recovery and reduces mortality, according to a study published in the Jan. 31 issue of the New England Journal of Medicine.

Indi Trehan, M.D., from Washington University in St. Louis, and colleagues examined the effect of adding routine antibiotic agents to nutritional therapy in a cohort of 2,767 Malawian children (6 to 59 months of age) with severe acute malnutrition, who were randomized to receive amoxicillin, cefdinir, or placebo for seven days, in addition to ready-to-use therapeutic food.

The researchers found that significantly more children recovered in the amoxicillin (88.7 percent) and cefdinir groups (90.9 percent) compared with the placebo group (85.1 percent) (relative risk [RR] of treatment failure with placebo versus amoxicillin, 1.32; RR with placebo versus cefdinir, 1.64). The mortality rates were 4.8 percent for amoxicillin, 4.1 percent for cefdinir, and 7.4 percent for placebo (RR of death with placebo versus amoxicillin, 1.55; RR with placebo versus cefdinir, 1.80). The rate of weight gain was higher among those who recovered and had received antibiotics.

"Our results suggest that children with uncomplicated severe acute malnutrition who qualify for outpatient therapy remain at risk for severe bacterial infection and that the routine inclusion of antibiotics as part of their nutritional therapy is warranted," the authors write.

Abstract (http://www.nejm.org/doi/full/10.1056/NEJMoa1202851?query=featured_home )Full Text (http://www.nejm.org/doi/full/10.1056/NEJMoa1202851?query=featured_home#t=article )