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Neonatal azithromycin administration and growth during infancy: a randomized controlled trial

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 wei...

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Main Authors: Sié, Ali (Author) , Bountogo, Mamadou (Author) , Zakane, Alphonse (Author) , Compaoré, Guillaume (Author) , Ouedraogo, Thierry (Author) , Ouattara, Mamadou (Author) , Lebas, Elodie (Author) , Brogdon, Jessica (Author) , Nyatigo, Fanice (Author) , O’Brien, Kieran S. (Author) , Porco, Travis C. (Author) , Bärnighausen, Till (Author) , Arnold, Benjamin F. (Author) , Lietman, Thomas M. (Author) , Oldenburg, Catherine E. (Author)
Format: Article (Journal)
Language:English
Published: 2023
In: The American journal of tropical medicine and hygiene
Year: 2023, Volume: 108, Issue: 5, Pages: 1063-1070
ISSN:1476-1645
DOI:10.4269/ajtmh.22-0763
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.4269/ajtmh.22-0763
Verlag, lizenzpflichtig, Volltext: https://www.ajtmh.org/view/journals/tpmd/108/5/article-p1063.xml
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Author Notes:Ali Sie, Mamadou Bountogo, Alphonse Zakane, Guillaume Compaoré, Thierry Ouedraogo, Mamadou Ouattara, Elodie Lebas, Jessica Brogdon, Fanice Nyatigo, Kieran S. O’Brien, Travis C. Porco, Till Bärnighausen, Benjamin F. Arnold, Thomas M. Lietman, Catherine E. Oldenburg for the NAITRE Study Team
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Summary: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.
Item Description:Gesehen am 25.07.2023
Physical Description:Online Resource
ISSN:1476-1645
DOI:10.4269/ajtmh.22-0763

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