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Commentary on: Trehan I, Goldbach HS, LaGrone LN, et al. Antibiotics as part of the management of severe acute malnutrition. N Engl J Med 2013;368:425–35.
Severe acute malnutrition (SAM) causes over one million child deaths per year.1 Community Management of Acute Malnutrition (CMAM) classifies clinically stable children with good appetite as having ‘uncomplicated SAM’. They are treated as outpatients using specially formulated ready-to-use therapeutic foods.2 Many programmes also give routine antibiotics. This is not evidence-based, but a continuation from old, inpatient-only, treatment approaches where children often presented late and were, hence, much sicker on admission. Since antibiotics also have costs and potential risks, this study evaluated their use in uncomplicated SAM.
This is a double-blind, placebo-controlled, randomised trial examining two different oral antibiotics, amoxicillin and cefdinir, given for 7 days at CMAM admission. A …
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