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A recent study conducted in Malawi by a team of scientists from Washington University in St. Louis, and published in the most recent edition of the New England Journal of Medicine, found that antibiotics given at the start of a longer course of therapeutic foods, such as Plumpy’nut, greatly increased malnutrition recovery and survival rates. Though researchers are still unsure of the exact mechanism, they posit that the antibiotics may help restore the balance of healthy bacteria in the gut, which may provide protection against future infections that could inhibit the ability to absorb food.

These are exciting findings, particularly given the fact that a week’s worth of the drugs – amoxicillin and cefdinir – costs only a few dollars, making this an affordable intervention for both donors and governments. However, I cannot help but wonder what the long-term effects of increased usage of these drugs over longer periods of time will be. Will overuse of these drugs lead to the production of resistant intestinal bacteria? If so, what alternative drugs could be made available? And how much would these new drugs cost? Moreover, in the face of frequent fuel shortages and inadequate transportation infrastructure, how can we ensure that adequate supplies are made available in rural health clinics? Donors, governments, and public health professionals must ensure that the necessary systems and contingency plans are in place if we are to truly reap the benefits of this promising new treatment.

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4 thoughts on “Malawi Malnutrition Study

  1. Jen – I was interested to read your latest post. From articles that I have read regarding “gut bacteria”, one of the negative side effects of taking antibiotics is that it kills the good bacteria as well as the bad bacteria. Thus, taking a probiotic after antibiotic therapy is highly recommended to bring the bacteria back into balance.

    Any thoughts about this?

    Love you! Mom

    • Good point, Mom.

      The two antibiotics used in the study were amoxicillin or cefdinir. I’m not sure whether these two drugs have been shown to kill “good” bacteria in the gut. But, even if they have, the long-term benefits may outweigh the short-term risks. Malnourished children are much more prone to infections and other problems that can interfere with nutrient absorption in the gut. So reducing the amount of “good” bacteria in a child’s gut over the short-term is probably a better option than not treating the child with antibiotics and risking a return to malnourishment and/or the development of more serious infections that could have long-term effects on nutrient absorption.

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