The impact of antibiotics on growth in children in low and middle income countries: systematic review and meta-analysis of randomised controlled trials.
BMJ
; 348: g2267, 2014 Apr 15.
Article
en En
| MEDLINE
| ID: mdl-24735883
ABSTRACT
OBJECTIVES:
To determine whether antibiotic treatment leads to improvements in growth in prepubertal children in low and middle income countries, to determine the magnitude of improvements in growth, and to identify moderators of this treatment effect.DESIGN:
Systematic review and meta-analysis. DATA SOURCES Medline, Embase, Scopus, the Cochrane central register of controlled trials, and Web of Science. STUDY SELECTION Randomised controlled trials conducted in low or middle income countries in which an orally administered antibacterial agent was allocated by randomisation or minimisation and growth was measured as an outcome. Participants aged 1 month to 12 years were included. Control was placebo or non-antimicrobial intervention.RESULTS:
Data were pooled from 10 randomised controlled trials representing 4316 children, across a variety of antibiotics, indications for treatment, treatment regimens, and countries. In random effects models, antibiotic use increased height by 0.04 cm/month (95% confidence interval 0.00 to 0.07) and weight by 23.8 g/month (95% confidence interval 4.3 to 43.3). After adjusting for age, effects on height were larger in younger populations and effects on weight were larger in African studies compared with other regions.CONCLUSION:
Antibiotics have a growth promoting effect in prepubertal children in low and middle income countries. This effect was more pronounced for ponderal than for linear growth. The antibiotic growth promoting effect may be mediated by treatment of clinical or subclinical infections or possibly by modulation of the intestinal microbiota. Better definition of the mechanisms underlying this effect will be important to inform optimal and safe approaches to achieving healthy growth in vulnerable populations.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Desarrollo Infantil
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Sustancias de Crecimiento
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Países en Desarrollo
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Antibacterianos
Tipo de estudio:
Clinical_trials
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Systematic_reviews
Límite:
Child
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Child, preschool
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Humans
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Infant
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Newborn
Idioma:
En
Revista:
BMJ
Asunto de la revista:
MEDICINA
Año:
2014
Tipo del documento:
Article
País de afiliación:
Canadá