Related Experiment Video
Updated: Aug 5, 2025
Probiotic Studies in Neonatal Mice Using Gavage
Published on: January 27, 2019
Neonatal Azithromycin Administration and Growth during Infancy: A Randomized Controlled Trial
Ali Sie1, Mamadou Bountogo1, Alphonse Zakane1
1Centre de Recherche en Santé de Nouna, Burkina Faso.
Insights
Neonatal antibiotic exposure, specifically azithromycin, did not impact infant growth outcomes at six months in Burkina Faso. This study found no evidence of growth-promoting properties of azithromycin in neonates.
Area of Science:
- Global Health
- Pediatric Health
- Infectious Diseases
Background:
- Observational studies suggest early-life antibiotic exposure may increase childhood obesity risk in high-income countries.
- The impact of neonatal antibiotic administration on infant growth in low-income settings remains less understood.
Purpose of the Study:
- To evaluate the effect of a single neonatal dose of azithromycin on infant growth parameters at six months of age in Burkina Faso.
- To determine if azithromycin administration in neonates influences weight gain, length, and mid-upper-arm circumference (MUAC).
Main Methods:
- A randomized controlled trial involving 21,832 neonates (aged 8-27 days, weight ≥2,500g) in Burkina Faso.
- Participants received either a single oral dose of azithromycin (20 mg/kg) or a placebo.
- Growth outcomes including weight, length, MUAC, and Z-scores (WAZ, WLZ, LAZ) were measured at baseline and six months.
Main Results:
- No significant differences were observed in weight gain (mean difference -0.009 g/day), length change (mean difference 0.003 mm/day), or MUAC change (mean difference 0.01 cm) between the azithromycin and placebo groups.
- Similarly, no statistically significant differences were found in weight-for-age Z-score (WAZ), weight-for-length Z-score (WLZ), or length-for-age Z-score (LAZ).
- The study found no evidence that azithromycin administration in neonates promotes infant growth.
Conclusions:
- A single neonatal dose of azithromycin does not appear to alter infant growth trajectories at six months in the studied population in Burkina Faso.
- These findings do not support the hypothesis that azithromycin possesses growth-promoting properties when administered neonatally in this context.
- Further research may explore long-term effects or different antibiotic classes in diverse settings.
Abstract:
Observational studies have linked early-life antibiotic exposure to increased risk of obesity in children in high income settings. We evaluated whether neonatal antibiotic exposure led to changes in infant growth at 6 months of age in Burkina Faso. Neonates aged 8 to 27 days of age who weighed at least 2,500 g at the time of enrollment were randomized in a 1:1 fashion to a single oral 20-mg/kg dose of azithromycin or equivalent volume of placebo from April 2019 through December 2020. Weight, length, and mid-upper-arm circumference (MUAC) were measured at baseline and 6 months of age. Growth outcomes, including weight gain in grams per day, length change in millimeters per day, and changes in weight-for-age Z-score (WAZ), weight-for-length Z-score (WLZ), length-for-age Z-score (LAZ), and MUAC were compared among neonates randomized to azithromycin compared with placebo. Among 21,832 neonates enrolled in the trial, median age at enrollment was 11 days, and 50% were female. We found no evidence of a difference in weight gain (mean difference -0.009 g/day, 95% confidence interval [CI]: -0.16 to 0.14, P = 0.90), length change (mean difference 0.003 mm/day, 95% CI: -0.002 to 0.007, P = 0.23), or WAZ (mean difference -0.005 SD, 95% CI: -0.03 to 0.02, P = 0.72), WLZ (mean difference -0.01 SD, 95% CI: -0.05 to 0.02, P = 0.39), LAZ (mean difference 0.01, 95% CI: -0.02 to 0.04, P = 0.47), or MUAC (mean difference 0.01 cm, 95% CI: -0.02 to 0.04, P = 0.49). These results do not suggest that azithromycin has growth-promoting properties in infants when administered during the neonatal period. Trial registration: ClinicalTrials.gov NCT03682653.
