Skip to main content
Top
Published in: BMC Pediatrics 1/2021

Open Access 01-12-2021 | Azithromycin | Research article

Single-dose azithromycin for child growth in Burkina Faso: a randomized controlled trial

Authors: Ali Sié, Boubacar Coulibaly, Clarisse Dah, Mamadou Bountogo, Mamadou Ouattara, Guillaume Compaoré, Jessica M. Brogdon, William W. Godwin, Elodie Lebas, Thuy Doan, Benjamin F. Arnold, Travis C. Porco, Thomas M. Lietman, Catherine E. Oldenburg

Published in: BMC Pediatrics | Issue 1/2021

Login to get access

Abstract

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.
Appendix
Available only for authorised users
Literature
5.
go back to reference Keenan JD, Arzika AM, Maliki R, et al. Cause-specific mortality of children younger than 5 years in communities receiving biannual mass azithromycin treatment in Niger: verbal autopsy results from a cluster-randomised controlled trial. Lancet Glob Heal. 2020;8:288–95.CrossRef Keenan JD, Arzika AM, Maliki R, et al. Cause-specific mortality of children younger than 5 years in communities receiving biannual mass azithromycin treatment in Niger: verbal autopsy results from a cluster-randomised controlled trial. Lancet Glob Heal. 2020;8:288–95.CrossRef
7.
go back to reference Jones KD, Thitiri J, Ngari M, Berkley JA. Childhood malnutrition: Toward an understanding of infections , inflammation , and antimicrobials. Food Nutr Bull 2014; 35: S64–S70, Childhood Malnutrition: Toward an Understanding of Infections, Inflammation, and Antimicrobials, 2_suppl1, DOI: https://doi.org/10.1177/15648265140352S110. Jones KD, Thitiri J, Ngari M, Berkley JA. Childhood malnutrition: Toward an understanding of infections , inflammation , and antimicrobials. Food Nutr Bull 2014; 35: S64–S70, Childhood Malnutrition: Toward an Understanding of Infections, Inflammation, and Antimicrobials, 2_suppl1, DOI: https://​doi.​org/​10.​1177/​15648265140352S1​10.
8.
10.
go back to reference Gough EK, Moodie EEM, Prendergast AJ, Johnson SMA, Humphrey JH, Stoltzfus RJ, Walker AS, Trehan I, Gibb DM, Goto R, Tahan S, de Morais MB, Manges AR. The impact of antibiotics on growth in children in low and middle income countries: systematic review and meta-analysis of randomised controlled trials. BMJ. 2014;348(apr15 6):g2267. https://doi.org/10.1136/bmj.g2267.CrossRefPubMedPubMedCentral Gough EK, Moodie EEM, Prendergast AJ, Johnson SMA, Humphrey JH, Stoltzfus RJ, Walker AS, Trehan I, Gibb DM, Goto R, Tahan S, de Morais MB, Manges AR. The impact of antibiotics on growth in children in low and middle income countries: systematic review and meta-analysis of randomised controlled trials. BMJ. 2014;348(apr15 6):g2267. https://​doi.​org/​10.​1136/​bmj.​g2267.CrossRefPubMedPubMedCentral
11.
go back to reference Doan T, Hinterwirth A, Worden L, Arzika AM, Maliki R, Abdou A, Kane S, Zhong L, Cummings SL, Sakar S, Chen C, Cook C, Lebas E, Chow ED, Nachamkin I, Porco TC, Keenan JD, Lietman TM. Gut microbiome alteration in MORDOR I: a community-randomized trial of mass azithromycin distribution. Nat Med. 2019;25(9):1370–6. https://doi.org/10.1038/s41591-019-0533-0.CrossRefPubMed Doan T, Hinterwirth A, Worden L, Arzika AM, Maliki R, Abdou A, Kane S, Zhong L, Cummings SL, Sakar S, Chen C, Cook C, Lebas E, Chow ED, Nachamkin I, Porco TC, Keenan JD, Lietman TM. Gut microbiome alteration in MORDOR I: a community-randomized trial of mass azithromycin distribution. Nat Med. 2019;25(9):1370–6. https://​doi.​org/​10.​1038/​s41591-019-0533-0.CrossRefPubMed
12.
go back to reference Burr SE, Hart J, Edwards T, et al. Anthropometric indices of Gambian children after one or three annual rounds of mass drug administration with azithromycin for trachoma control. BMC Public Health. 2014;14:481–8.CrossRef Burr SE, Hart J, Edwards T, et al. Anthropometric indices of Gambian children after one or three annual rounds of mass drug administration with azithromycin for trachoma control. BMC Public Health. 2014;14:481–8.CrossRef
16.
go back to reference Munoz B, Solomon AW, Zingeser J, et al. Antibiotic dosage in trachoma control programs : height as a surrogate for weight in children. Invest Ophthalmol Vis Sci. 2002;44:1464–9.CrossRef Munoz B, Solomon AW, Zingeser J, et al. Antibiotic dosage in trachoma control programs : height as a surrogate for weight in children. Invest Ophthalmol Vis Sci. 2002;44:1464–9.CrossRef
18.
go back to reference WHO Multicentre Growth Reference Study Group. WHO Child Growth Standards: Length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age: Methods and development. Geneva: World Heal Organ; 2006. p. 312. WHO Multicentre Growth Reference Study Group. WHO Child Growth Standards: Length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age: Methods and development. Geneva: World Heal Organ; 2006. p. 312.
20.
go back to reference Sie A, Dah C, Bountogo M, et al. Adverse events and clinic visits following a single dose of oral azithromycin among preschool children: a randomized placebo-controlled trial. Am J Trop Med Hyg. 2020; In press. Sie A, Dah C, Bountogo M, et al. Adverse events and clinic visits following a single dose of oral azithromycin among preschool children: a randomized placebo-controlled trial. Am J Trop Med Hyg. 2020; In press.
21.
go back to reference Porco TC, Hart J, Arzika AM, et al. Mass Oral Azithromycin for Childhood Mortality : Timing of Death After Distribution in the MORDOR Trial. Clin Infect Dis. 2018:1–3. Porco TC, Hart J, Arzika AM, et al. Mass Oral Azithromycin for Childhood Mortality : Timing of Death After Distribution in the MORDOR Trial. Clin Infect Dis. 2018:1–3.
28.
go back to reference Rogawski ET, Liu J, Platts-Mills JA, Kabir F, Lertsethtakarn P, Siguas M, Khan SS, Praharaj I, Murei A, Nshama R, Mujaga B, Havt A, Maciel IA, Operario DJ, Taniuchi M, Gratz J, Stroup SE, Roberts JH, Kalam A, Aziz F, Qureshi S, Islam MO, Sakpaisal P, Silapong S, Yori PP, Rajendiran R, Benny B, McGrath M, Seidman JC, Lang D, Gottlieb M, Guerrant RL, Lima AAM, Leite JP, Samie A, Bessong PO, Page N, Bodhidatta L, Mason C, Shrestha S, Kiwelu I, Mduma ER, Iqbal NT, Bhutta ZA, Ahmed T, Haque R, Kang G, Kosek MN, Houpt ER, Acosta AM, Rios de Burga R, Chavez CB, Flores JT, Olotegui MP, Pinedo SR, Trigoso DR, Vasquez AO, Ahmed I, Alam D, Ali A, Rasheed M, Soofi S, Turab A, Yousafzai A, Zaidi AKM, Shrestha B, Rayamajhi BB, Strand T, Ammu G, Babji S, Bose A, George AT, Hariraju D, Jennifer MS, John S, Kaki S, Karunakaran P, Koshy B, Lazarus RP, Muliyil J, Ragasudha P, Raghava MV, Raju S, Ramachandran A, Ramadas R, Ramanujam K, Rose A, Roshan R, Sharma SL, Sundaram S, Thomas RJ, Pan WK, Ambikapathi R, Carreon JD, Doan V, Hoest C, Knobler S, Miller MA, Psaki S, Rasmussen Z, Richard SA, Tountas KH, Svensen E, Amour C, Bayyo E, Mvungi R, Pascal J, Yarrot L, Barrett L, Dillingham R, Petri WA, Scharf R, Ahmed AMS, Alam MA, Haque U, Hossain MI, Islam M, Mahfuz M, Mondal D, Nahar B, Tofail F, Chandyo RK, Shrestha PS, Shrestha R, Ulak M, Bauck A, Black R, Caulfield L, Checkley W, Lee G, Schulze K, Scott S, Murray-Kolb LE, Ross AC, Schaefer B, Simons S, Pendergast L, Abreu CB, Costa H, di Moura A, Filho JQ, Leite ÁM, Lima NL, Lima IF, Maciel BLL, Medeiros PHQS, Moraes M, Mota FS, Oriá RB, Quetz J, Soares AM, Mota RMS, Patil CL, Mahopo C, Maphula A, Nyathi E. Use of quantitative molecular diagnostic methods to investigate the effect of enteropathogen infections on linear growth in children in low-resource settings : longitudinal analysis of results from the MAL-ED cohort study. Lancet Glob Heal. 2018;6(12):e1319–28. https://doi.org/10.1016/S2214-109X(18)30351-6.CrossRef Rogawski ET, Liu J, Platts-Mills JA, Kabir F, Lertsethtakarn P, Siguas M, Khan SS, Praharaj I, Murei A, Nshama R, Mujaga B, Havt A, Maciel IA, Operario DJ, Taniuchi M, Gratz J, Stroup SE, Roberts JH, Kalam A, Aziz F, Qureshi S, Islam MO, Sakpaisal P, Silapong S, Yori PP, Rajendiran R, Benny B, McGrath M, Seidman JC, Lang D, Gottlieb M, Guerrant RL, Lima AAM, Leite JP, Samie A, Bessong PO, Page N, Bodhidatta L, Mason C, Shrestha S, Kiwelu I, Mduma ER, Iqbal NT, Bhutta ZA, Ahmed T, Haque R, Kang G, Kosek MN, Houpt ER, Acosta AM, Rios de Burga R, Chavez CB, Flores JT, Olotegui MP, Pinedo SR, Trigoso DR, Vasquez AO, Ahmed I, Alam D, Ali A, Rasheed M, Soofi S, Turab A, Yousafzai A, Zaidi AKM, Shrestha B, Rayamajhi BB, Strand T, Ammu G, Babji S, Bose A, George AT, Hariraju D, Jennifer MS, John S, Kaki S, Karunakaran P, Koshy B, Lazarus RP, Muliyil J, Ragasudha P, Raghava MV, Raju S, Ramachandran A, Ramadas R, Ramanujam K, Rose A, Roshan R, Sharma SL, Sundaram S, Thomas RJ, Pan WK, Ambikapathi R, Carreon JD, Doan V, Hoest C, Knobler S, Miller MA, Psaki S, Rasmussen Z, Richard SA, Tountas KH, Svensen E, Amour C, Bayyo E, Mvungi R, Pascal J, Yarrot L, Barrett L, Dillingham R, Petri WA, Scharf R, Ahmed AMS, Alam MA, Haque U, Hossain MI, Islam M, Mahfuz M, Mondal D, Nahar B, Tofail F, Chandyo RK, Shrestha PS, Shrestha R, Ulak M, Bauck A, Black R, Caulfield L, Checkley W, Lee G, Schulze K, Scott S, Murray-Kolb LE, Ross AC, Schaefer B, Simons S, Pendergast L, Abreu CB, Costa H, di Moura A, Filho JQ, Leite ÁM, Lima NL, Lima IF, Maciel BLL, Medeiros PHQS, Moraes M, Mota FS, Oriá RB, Quetz J, Soares AM, Mota RMS, Patil CL, Mahopo C, Maphula A, Nyathi E. Use of quantitative molecular diagnostic methods to investigate the effect of enteropathogen infections on linear growth in children in low-resource settings : longitudinal analysis of results from the MAL-ED cohort study. Lancet Glob Heal. 2018;6(12):e1319–28. https://​doi.​org/​10.​1016/​S2214-109X(18)30351-6.CrossRef
29.
go back to reference Mertens A, Benjamin-Chung J, Colford JM, et al. Causes and consequences of child growth failure in low- and middle-income countries. MedRxiv 2020. Mertens A, Benjamin-Chung J, Colford JM, et al. Causes and consequences of child growth failure in low- and middle-income countries. MedRxiv 2020.
30.
Metadata
Title
Single-dose azithromycin for child growth in Burkina Faso: a randomized controlled trial
Authors
Ali Sié
Boubacar Coulibaly
Clarisse Dah
Mamadou Bountogo
Mamadou Ouattara
Guillaume Compaoré
Jessica M. Brogdon
William W. Godwin
Elodie Lebas
Thuy Doan
Benjamin F. Arnold
Travis C. Porco
Thomas M. Lietman
Catherine E. Oldenburg
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2021
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-021-02601-7

Other articles of this Issue 1/2021

BMC Pediatrics 1/2021 Go to the issue