Treatment of severe malnutrition with 2-day intramuscular ceftriaxone vs 5-day amoxicillin.

Hdl Handle:
http://hdl.handle.net/10144/52213
Title:
Treatment of severe malnutrition with 2-day intramuscular ceftriaxone vs 5-day amoxicillin.
Authors:
Dubray, C; Ibrahim, S A; Abdelmutalib, M; Guerin, P J; Dantoine, F; Belanger, F; Legros, D; Pinoges, L; Brown, V
Journal:
Annals of Tropical Paediatrics
Abstract:
BACKGROUND: Systemic antibiotics are routinely prescribed for severe acute malnutrition (SAM). However, there is no consensus regarding the most suitable regimen. In a therapeutic feeding centre in Khartoum, Sudan, a randomised, unblinded, superiority-controlled trial was conducted, comparing once daily intramuscular injection with ceftriaxone for 2 days with oral amoxicillin twice daily for 5 days in children aged 6-59 months with SAM. METHODS: Commencing with the first measured weight gain (WG) following admission, the risk difference and 95% confidence interval (95% CI) for children with a WG > or = 10 g/kg/day were calculated over a 14-day period. The recovery rate and case fatality ratio (CFR) between the two groups were also calculated. RESULTS: In an intention-to-treat analysis of 458 children, 53.5% (123/230) in the amoxicillin group and 55.7% (127/228, difference 2.2%, 95% CI -6.9-11.3) in the ceftriaxone group had a WG > or = 10 g/kg/day during a 14-day period. Recovery rate was 70% (161/230) in the amoxicillin group and 74.6% (170/228) in the ceftriaxone group (p=0.27). CFR was 3.9% (9/230) and 3.1% (7/228), respectively (p=0.67). Most deaths occurred within the 1st 2 weeks of admission. CONCLUSION: In the absence of severe complications, either ceftriaxone or amoxicillin is appropriate for malnourished children. However, in ambulatory programmes, especially where there are large numbers of admissions, ceftriaxone should facilitate the work of medical personnel.
Affiliation:
Epicentre, Paris, France.
Publisher:
Maney Publishing
Issue Date:
Mar-2008
URI:
http://hdl.handle.net/10144/52213
DOI:
10.1179/146532808X270635
PubMed ID:
18318945
Additional Links:
http://www.maney.co.uk/journals/atp
Submitted date:
2009-03-04
Type:
Article
Language:
en
ISSN:
0272-4936
Sponsors:
Epicentre
Appears in Collections:
Nutrition

Full metadata record

DC FieldValue Language
dc.contributor.authorDubray, C-
dc.contributor.authorIbrahim, S A-
dc.contributor.authorAbdelmutalib, M-
dc.contributor.authorGuerin, P J-
dc.contributor.authorDantoine, F-
dc.contributor.authorBelanger, F-
dc.contributor.authorLegros, D-
dc.contributor.authorPinoges, L-
dc.contributor.authorBrown, V-
dc.date.accessioned2009-03-05T09:05:00Z-
dc.date.available2009-03-05T09:05:00Z-
dc.date.issued2008-03-
dc.date.submitted2009-03-04-
dc.identifier.citationTreatment of severe malnutrition with 2-day intramuscular ceftriaxone vs 5-day amoxicillin. 2008, 28 (1):13-22notAnn Trop Paediatren
dc.identifier.issn0272-4936-
dc.identifier.pmid18318945-
dc.identifier.doi10.1179/146532808X270635-
dc.identifier.urihttp://hdl.handle.net/10144/52213-
dc.description.abstractBACKGROUND: Systemic antibiotics are routinely prescribed for severe acute malnutrition (SAM). However, there is no consensus regarding the most suitable regimen. In a therapeutic feeding centre in Khartoum, Sudan, a randomised, unblinded, superiority-controlled trial was conducted, comparing once daily intramuscular injection with ceftriaxone for 2 days with oral amoxicillin twice daily for 5 days in children aged 6-59 months with SAM. METHODS: Commencing with the first measured weight gain (WG) following admission, the risk difference and 95% confidence interval (95% CI) for children with a WG > or = 10 g/kg/day were calculated over a 14-day period. The recovery rate and case fatality ratio (CFR) between the two groups were also calculated. RESULTS: In an intention-to-treat analysis of 458 children, 53.5% (123/230) in the amoxicillin group and 55.7% (127/228, difference 2.2%, 95% CI -6.9-11.3) in the ceftriaxone group had a WG > or = 10 g/kg/day during a 14-day period. Recovery rate was 70% (161/230) in the amoxicillin group and 74.6% (170/228) in the ceftriaxone group (p=0.27). CFR was 3.9% (9/230) and 3.1% (7/228), respectively (p=0.67). Most deaths occurred within the 1st 2 weeks of admission. CONCLUSION: In the absence of severe complications, either ceftriaxone or amoxicillin is appropriate for malnourished children. However, in ambulatory programmes, especially where there are large numbers of admissions, ceftriaxone should facilitate the work of medical personnel.en
dc.description.sponsorshipEpicentreen
dc.language.isoenen
dc.publisherManey Publishingen
dc.relation.urlhttp://www.maney.co.uk/journals/atpen
dc.rightsPublished by Maney Publishing Archived on this site with kind permission of Maney Publishing ([url]http://www.maney.co.uk/journals/atp[/url])en
dc.subject.meshAdministration, Oralen
dc.subject.meshAge Factorsen
dc.subject.meshAmoxicillinen
dc.subject.meshAnthropometryen
dc.subject.meshAnti-Bacterial Agentsen
dc.subject.meshCeftriaxoneen
dc.subject.meshChild, Preschoolen
dc.subject.meshDrug Administration Scheduleen
dc.subject.meshFemaleen
dc.subject.meshHumansen
dc.subject.meshInfanten
dc.subject.meshInfant Nutrition Disordersen
dc.subject.meshInjections, Intramuscularen
dc.subject.meshLength of Stayen
dc.subject.meshMaleen
dc.subject.meshOpportunistic Infectionsen
dc.subject.meshTreatment Outcomeen
dc.subject.meshWeight Gainen
dc.titleTreatment of severe malnutrition with 2-day intramuscular ceftriaxone vs 5-day amoxicillin.en
dc.typeArticleen
dc.contributor.departmentEpicentre, Paris, France.en
dc.identifier.journalAnnals of Tropical Paediatricsen
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