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Randomised controlled trial
Routine antibiotics given for uncomplicated severe acute malnutrition reduce mortality and improve nutritional recovery
  1. Marko Kerac
  1. Department of Epidemiology and Public Health, Leonard Cheshire Disability and Inclusive Development Centre, University College London, London, UK
  1. Correspondence to: Dr Marko Kerac
    Department of Epidemiology and Public Health, Leonard Cheshire Disability and Inclusive Development Centre, University College London, 1-19 Torrington Place, London WC1E 6BT, UK; marko.kerac{at}gmail.com

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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.

Context

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.

Methods

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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