evidence-based blog of Filippo Dibari

Randomized, Double-Blind, Placebo-Controlled Trial Evaluating the Need for Routine Antibiotics as Part of the Outpatient Management of Severe Acute Malnutrition (2012)

In Under-nutrition on May 25, 2012 at 9:07 am

from FANTA:

“Severe acute malnutrition (SAM) in children contributes to the deaths of 1 million children every year. Until recently, children with SAM were treated as inpatients in crowded hospital wards with milk-based therapy and routine antibiotics for all children. With the advent and widespread acceptance of peanut-based ready-to-use-therapeutic food (RUTF), standard therapy for SAM without medical complications is to treat these children at home.

Even in the home setting, international guidelines recommend that children receive a course of oral antibiotics at the start of their RUTF therapy. Because this places an additional burden on already taxed health systems and caregivers, because clinical experience has shown good recovery rates without antibiotics, and because the bacteria most likely to cause severe infections in these children are unlikely to be susceptible to most options for routine antibiotics, their routine use has been called into question. Thus, FANTA undertook a clinical trial comparing nutritional recovery and mortality outcomes in children with SAM receiving 1 week of amoxicillin, cefdinir, or placebo, in addition to usual RUTF therapy. This report documents the outcomes of the trial, which clearly showed the benefit of using antibiotics in the outpatient treatment of SAM without medical complications”.

Download the document

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