Malnutrition threatens the lives of millions of children under age 5, causing about 500,000 deaths per year in low- and middle-income countries. Short courses of antibiotics paired with a therapeutic peanut butter-based food are the standard of care for treating severe acute malnutrition in children — but using antibiotics in this vulnerable population is controversial; public health experts worry about the worsening problem of antibiotic resistance.
Now, a new study led by Gautam Dantas, PhD, at Washington University School of Medicine in St. Louis shows that the concerns of increasing antibiotic resistance have merit but that the long-term benefits may outweigh the short-term risks. The findings – published Oct. 19 in The Lancet Microbe – indicate a diverse, more mature gut microbiome in malnourished Nigerien children two years after antibiotic treatment. Brief increases in antibiotic resistance genes in gut bacteria after the children were treated completely dissipated within three weeks.
Antibiotics can perturb the microbiome and increase infection risks, which is a concern in immunocompromised, malnourished children already prone to infection. But we show improvements in microbiome maturation years after a short course of antibiotics compared to placebo, an important finding given that stunted microbiome development is linked to adverse malnutrition outcomes in malnourished children. This study provides evidence that while we should be careful in the use of antibiotics, the risk of a brief increase in drug-resistant bacteria is likely outweighed by the benefit of these persistent microbiome improvements.”
Gautam Dantas, PhD, the study’s co-senior author and