International guidelines recommend that children with severe acute malnutrition (SAM) receive a course of oral antibiotics at the start of taking ready-to-use-therapeutic food (RUTF), even in the home setting. However, its routine use has been questioned because it places an additional burden on already taxed health systems and caregivers, clinical experience has shown good recovery rates without antibiotics, and the bacteria most likely to cause severe infections in these children are unlikely to be susceptible to most options for routine antibiotics. FANTA partner Washington University in St. Louis carried out a study to compare nutritional recovery and mortality outcomes in children with SAM receiving 1 week of amoxicillin, cefdinir, or placebo, in addition to usual RUTF therapy. The randomized clinical trial clearly showed the benefit of using antibiotics in the outpatient treatment of SAM without medical complications in a setting with high levels of kwashiorkor and HIV infection. The research report provides an abstract and detailed findings; the impact story offers a brief summary. In addition, the findings have been published in the New England Journal of Medicine.

Collaborating Organization: University of Malawi College of Medicine