Azithromycin in the Outpatient Management of Severe Acute Malnutrition

阿奇霉素在严重急性营养不良门诊治疗中的应用

• 批准号: 10056186
• 负责人: Catherine Elizabeth Oldenburg
• 金额: $ 18.52万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-06 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10056186
• 关键词: Acute; Adherence; Admission activity; Africa; Africa South of the Sahara; Age-Months; Amoxicillin; Antibiotics; Azithromycin; Burkina Faso; Caregivers; Cessation of life; Child; Child Mortality; Clinical; Communicable Diseases; Communities; Conflict (Psychology); Cotrimoxazole; Data; Development; Dose; Feasibility Studies; Guidelines; Half-Life; Immune system; Infection; Kwashiorkor; Lead; Malawi; Malnutrition; Morbidity - disease rate; Niger; Nutritional; Nutritional status; Oral; Outpatients; Pilot Projects; Placebos; Prevalence; Procedures; Randomized; Randomized Controlled Trials; Recovery; Risk; Role; Sampling; Tanzania; Testing; Time; Trachoma; Underweight; Ursidae Family; Visit; Weight Gain; World Health Organization; aged; arm; efficacy testing; evidence based guidelines; follow-up; improved; improved outcome; mortality; mortality risk; peer; primary outcome; programs; randomized placebo controlled trial; rural area; standard of care; trial comparing; wasting

PROJECT SUMMARY/ABSTRACT Amoxicillin is recommended by the World Health Organization (WHO) as adjunctive therapy for the treatment of uncomplicated severe acute malnutrition (SAM). Because children with uncomplicated SAM are more likely to have asymptomatic infection, presumptive treatment with a broad-spectrum antibiotic may be beneficial by clearing any existing infection and improving outcomes. Two randomized placebo-controlled randomized trials have evaluated amoxicillin for uncomplicated SAM and have found conflicting results. These results may indicate either that antibiotics are not helpful for the management of uncomplicated SAM, or that a better antibiotic is needed. Recently, we demonstrated that biannual mass azithromycin distribution as a single oral dose reduces all-cause child mortality in sub-Saharan Africa. Children with uncomplicated SAM, who have an elevated risk of mortality relative to their well-nourished peers, may particularly benefit from presumptive azithromycin treatment. Here, we propose a pilot and feasibility study to evaluate the potential for development of a full-scale randomized controlled trial to test a single dose of azithromycin as compared to amoxicillin and placebo. We anticipate that the results will provide valuable pilot data and allow for refinement of study procedures, allowing for development of a full-scale randomized controlled trial to provide evidence for the role of azithromycin in the management of uncomplicated SAM.

项目总结/文摘