The impact of antibiotics on growth in children in low and middle income countries
Systematic review and meta-analysis of randomised controlled trial
According to recent data from the World Health Organization, about 6.6 million children worldwide died before their 5th birthday in 2012, with the United Kingdom accounting for 4065 deaths.1 This represents a remarkable 45% reduction from almost 12 million deaths in 1990.2 There are multiple risk factors for early child mortality, including infection, poor sanitation, and hygiene, but it is estimated that malnutrition underlies one third of these deaths. Researchers are slowly unravelling the links between subclinical infection, chronic enteropathy, and growth failure among children in low and middle income countries.
To develop new hypotheses doctors and researchers have turned to practices used in the food industry, where poor sanitation and hygiene are known to impair growth. Farmers often supplement animal feeds with low dose broad spectrum antibiotics to improve meat yields. But would the same strategy work for human growth? Antibiotics have variable effects on growth, but are currently