Related Experiment Video
Updated: May 6, 2026
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Single-dose azithromycin for infant growth in Burkina Faso: Prespecified secondary anthropometric outcomes from a
Ali Sié1,2, Mamadou Ouattara1, Mamadou Bountogo1
1Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso.
Insights
A single dose of azithromycin given to infants did not impact their weight or height at six months. This study investigated infant growth outcomes following early antibiotic exposure in Burkina Faso.
Area of Science:
- Pediatric Health
- Infectious Diseases
- Global Health
Background:
- Early antibiotic exposure in infancy is a potential risk factor for childhood obesity in high-income nations.
- Undernutrition is prevalent in rural Burkina Faso, necessitating an evaluation of infant growth interventions.
Purpose of the Study:
- To assess the impact of a single oral dose of azithromycin on infant growth outcomes at six months of age.
- To evaluate anthropometric changes in infants receiving azithromycin versus placebo in a low-income setting.
Main Methods:
- A randomized controlled trial involving 32,877 infants aged 5-12 weeks in Burkina Faso.
- Infants received either a single oral dose of azithromycin (20 mg/kg) or a placebo during well-child visits.
- Anthropometric measurements (weight, height, Z-scores, MUAC) were collected at enrollment and six months.
Main Results:
- No significant differences were observed in weight gain, height change, weight-for-age Z-score (WAZ), weight-for-length Z-score (WLZ), length-for-age Z-score (LAZ), or mid-upper arm circumference (MUAC) at six months.
- The study followed 27,298 (83%) infants to the six-month assessment.
- Mean differences between azithromycin and placebo groups were negligible for all anthropometric endpoints.
Conclusions:
- A single infant dose of azithromycin does not appear to influence key weight and height outcomes at six months.
- Findings suggest limited impact of early, single-dose azithromycin on infant growth trajectories in this undernourished population.
Background:
Antibiotic use during early infancy has been linked to childhood obesity in high-income countries. We evaluated whether a single oral dose of azithromycin administered during infant-well visits led to changes in infant growth outcomes at 6 months of age in a setting with a high prevalence of undernutrition in rural Burkina Faso.
Methods And Findings:
Infants were enrolled from September 25, 2019, until October 22, 2022, in a randomized controlled trial designed to evaluate the efficacy of a single oral dose of azithromycin (20 mg/kg) compared to placebo when administered during well-child visits for prevention of infant mortality. The trial found no evidence of a difference in the primary endpoint. This paper presents prespecified secondary anthropometric endpoints including weight gain (g/day), height change (mm/day), weight-for-age Z-score (WAZ), weight-for-length Z-score (WLZ), length-for-age Z-score (LAZ), and mid-upper arm circumference (MUAC). Infants were eligible for the trial if they were between 5 and 12 weeks of age, able to orally feed, and their families were planning to remain in the study area for the duration of the study. Anthropometric measurements were collected at enrollment (5 to 12 weeks of age) and 6 months of age. Among 32,877 infants enrolled in the trial, 27,298 (83%) were followed and had valid anthropometric measurements at 6 months of age. We found no evidence of a difference in weight gain (mean difference 0.03 g/day, 95% confidence interval (CI) -0.12 to 0.18), height change (mean difference 0.004 mm/day, 95% CI -0.05 to 0.06), WAZ (mean difference -0.004 SD, 95% CI -0.03 to 0.02), WLZ (mean difference 0.001 SD, 95% CI -0.03 to 0.03), LAZ (mean difference -0.005 SD, 95% CI -0.03 to 0.02), or MUAC (mean difference 0.01 cm, 95% CI -0.01 to 0.04). The primary limitation of the trial was that measurements were only collected at enrollment and 6 months of age, precluding assessment of shorter-term or long-term changes in growth.
Conclusions:
Single-dose azithromycin does not appear to affect weight and height outcomes when administered during early infancy.
Trial Registration:
ClinicalTrials.gov NCT03676764.
Related Concept Videos
01:11Bioavailability Study Design: Single Versus Multiple Dose Studies
01:29Drug Dosing: Infants and Children
01:23Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion