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Single-dose azithromycin for child growth in Burkina Faso: a randomized controlled trial
Ali Sié1, Boubacar Coulibaly1, Clarisse Dah1
1Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso.
Insights
Single-dose azithromycin showed a transient increase in weight gain velocity in children in Burkina Faso. This short-term benefit in weight gain was not sustained at six months.
Area of Science:
- Global Health
- Pediatric Nutrition
- Infectious Diseases
Background:
- Previous studies in low-resource settings indicated increased weight gain in children after antibiotic use for acute illness.
- Antibiotic administration, particularly azithromycin, has been linked to altered growth patterns in pediatric populations.
Purpose of the Study:
- To evaluate the impact of a single oral dose of azithromycin on weight gain velocity in a general pediatric population in Burkina Faso.
- To determine if azithromycin treatment leads to sustained weight gain over a six-month period.
Main Methods:
- An individually randomized controlled trial involving 450 children aged 8 days to 59 months in Burkina Faso.
- Participants received either a single oral dose of azithromycin (20 mg/kg) or a matching placebo.
- Weight gain velocity was assessed at 14 days and 6 months post-enrollment using anthropometric measurements.
Main Results:
- At 14 days, children receiving azithromycin exhibited a statistically significant increase in weight gain velocity (mean difference 0.9 g/kg/day, P=0.01) compared to the placebo group.
- No significant difference in weight gain velocity was observed between the azithromycin and placebo groups at the 6-month follow-up (P=0.46).
- No significant differences were found in other anthropometric outcomes between the groups.
Conclusions:
- Single-dose azithromycin treatment resulted in a transient, short-term increase in weight gain velocity in young children in Burkina Faso.
- The observed weight gain benefits from azithromycin were not sustained at the six-month follow-up.
- Further research may explore the long-term implications and potential mechanisms of transient weight changes following azithromycin administration in pediatric populations.
Background:
In lower resource settings, previous randomized controlled trials have demonstrated evidence of increased weight gain following antibiotic administration in children with acute illness. We conducted an individually randomized trial to assess whether single dose azithromycin treatment causes weight gain in a general population sample of children in Burkina Faso.
Methods:
Children aged 8 days to 59 months were enrolled in November 2019 and followed through June 2020 in Nouna Town, Burkina Faso. Participants were randomly assigned to a single oral dose of azithromycin (20 mg/kg) or matching placebo. Anthropometric measurements were collected at baseline and 14 days and 6 months after enrollment. The primary anthropometric outcome was weight gain velocity in g/kg/day from baseline to 14 days and 6 months in separate linear regression models.
Results:
Of 450 enrolled children, 230 were randomly assigned to azithromycin and 220 to placebo. Median age was 26 months (IQR 16 to 38 months) and 51% were female. At 14 days, children in the azithromycin arm gained a mean difference of 0.9 g/kg/day (95% CI 0.2 to 1.6 g/kg/day, P = 0.01) more than children in the placebo arm. There was no difference in weight gain velocity in children receiving azithromycin compared to placebo at 6 months (mean difference 0.04 g/kg/day, 95% CI - 0.05 to 0.13 g/kg/day, P = 0.46). There were no significant differences in other anthropometric outcomes.
Conclusions:
Transient increases in weight gain were observed after oral azithromycin treatment, which may provide short-term benefits.
Clinical Trials Registration:
ClinicalTrials.gov NCT03676751 . Registered 19/09/2018.
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