APUA Staff, along with members of its Scientific Advisory Board wrote a Letter to the Editor published in the New England Journal of Medicine (NEJM) on June 20, 2013.

On January 31, 2013, The New England Journal of Medicine published a research article titled, "Antibiotics as Part of the Management of Severe Acute Malnutrition" by Trehan et al. The researchers conducted a study of almost 3,000 Malawian children diagnosed with severe acute malnutrition that sought to determine the effect of antibiotics on the health outcomes of severely malnourished children who were not ill with an infectious disease. Along with the administering of ready-to-use therapeutic food (RUTF) treatment in these outpatients, children were either given amoxicillin, cefdinir, or a placebo. The study found statistically significant differences in the children's outcomes, suggesting that the routine administration of antibiotics in addition to therapeutic regimens for uncomplicated severe acute malnutrition may significantly improve recovery and mortality rates.

As a proponent for antimicrobial stewardship and the prudent use of antibiotics, APUA is concerned that the conclusions of this research may lead to the widespread and uncontrolled use of antibiotics for treating malnutrition before further research into the causal relationship between antibiotics and nutrition can be completed.

Responses from APUA Scientific Advisory Board

Iruka Okeke, USA & Nigeria

Jose Ramiro Cruz & Gerald Keusch

Responses from the community

Microbe Magazine published a Minitopic entitled, "Cautions Raised over Using Antibiotics as a Nutritional Supplement," in their September 2013 issue. The Minitopic quotes Dr. Stuart Levy, and discusses the concerns we raised in response to the NEJM article.


Breastfeeding and Nutrition

Cost Analysis of Maternal Disease Associated With Suboptimal Breastfeeding

The Burden of Suboptimal Breastfeeding in the United States: A Pediatric Cost Analysis

Alternative Treatments from Around the Globe

The Guardian: Follow the Niger and Mali models to tackle malnutrition

APUA Newsletter: Probiotics for Prevention and Adjunctive Therapy