Do children with uncomplicated severe acute malnutrition need antibiotics?

Added March 8, 2018

Citation: Alcoba G., Kerac M., Breysse S., et al. Do children with uncomplicated severe acute malnutrition need antibiotics? A Systematic Review and Meta-Analysis. PLoS ONE, 2013;8(1):1-9.

The evidence underlying current antibiotic recommendations for uncomplicated severe acute malnutrition (SAM) is weak. Susceptibility- studies favour amoxicillin over cotrimoxazole. However, given that these antibiotics have side-effects, costs, and risks as well as benefits, their routine use needs urgent testing. With reliable monitoring, we believe that there is sufficient equipoise for placebo controlled RCTs, the only robust way to demonstrate true efficacy.

Children suffering from SAM are often treated with antibiotics according to WHO guidelines. In the case of children with uncomplicated SAM, the evidence behind recommendation may be reconsidered. This review aimed to assess the evidence, forty-five studies were included without geographical limitation, assessed using international guidelines. Results found the evidence supporting antibiotic treatment of uncomplicated SAM to be weak. Amoxicillin was found to be favoured over cotrimoxazole. Further research is required in the routine use of antibiotics to treat SAM, to provide more in depth, robust evidence.


Disclaimer: This summary has been written by staff and volunteers of Evidence Aid in order to make the content of the original document accessible to decision makers who are searching for the available evidence the prevention and treatment of malnutrition but may not have the time, initially, to read the original report in full. This summary is not intended as a substitute for the medical advice of physicians, other health workers, professional associations, guideline developers, or national governments and international agencies. If readers of this summary think that the evidence that is presented within it is relevant to their decision-making they should refer to the content and details of the original article, and the advice and guidelines offered by other sources of expertise, before making decisions. Evidence Aid cannot be held responsible for any decisions made about prevention or treatment of malnutirition on the basis of this summary alone.