@article {1031, title = {Gut Resistome after Antibiotics among Children with Uncomplicated Severe Acute Malnutrition: A Randomized Controlled Trial.}, journal = {Am J Trop Med Hyg}, volume = {107}, year = {2022}, month = {2022 Jul 13}, pages = {59-64}, abstract = {

A broad-spectrum antibiotic, typically amoxicillin, is included in many country guidelines as part of the management of uncomplicated severe acute malnutrition (SAM) in children without overt clinical symptoms of infection. Alternative antibiotics may be beneficial for children with SAM without increasing selection for beta-lactam resistance. We conducted a 1:1 randomized controlled trial of single dose azithromycin versus a 7-day course of amoxicillin for SAM. Children 6-59 months of age with uncomplicated SAM (mid-upper arm circumference \< 11.5 cm and/or weight-for-height Z-score \< -3) were enrolled in Boromo District, Burkina Faso, from June through October 2020. Rectal swabs were collected at baseline and 8 weeks after treatment and processed using DNA-Seq. We compared the resistome at the class level in children randomized to azithromycin compared with amoxicillin. We found no evidence of a difference in the distribution of genetic antibiotic resistance determinants to any antibiotic class 8 weeks after treatment. There was no difference in genetic macrolide resistance determinants (65\% azithromycin, 65\% placebo, odds ratio, OR, 1.00, 95\% confidence interval, CI, 0.43-2.34) or beta-lactam resistance determinants (82\% azithromycin, 83\% amoxicillin, OR 0.94, 95\% CI, 0.33-2.68) at 8 weeks. Although presence of genetic antibiotic resistance determinants to macrolides and beta-lactams was common, we found no evidence of a difference in the gut resistome 8 weeks after treatment. If there are earlier effects of antibiotics on selection for genetic antibiotic resistance determinants, the resistome may normalize by 8 weeks.

}, keywords = {Amoxicillin, Anti-Bacterial Agents, Azithromycin, Child, Drug Resistance, Bacterial, Humans, Macrolides, Severe Acute Malnutrition}, issn = {1476-1645}, doi = {10.4269/ajtmh.22-0007}, author = {Oldenburg, Catherine E and Hinterwirth, Armin and Ourohir{\'e}, Millogo and Dah, Clarisse and Ou{\'e}draogo, Moussa and Sie, Ali and Boudo, Valentin and Chen, Cindi and Ruder, Kevin and Zhong, Lina and Lebas, Elodie and Nyatigo, Fanice and Arnold, Benjamin F and O{\textquoteright}Brien, Kieran S and Doan, Thuy} } @article {171, title = {Gut Resistome After Oral Antibiotics in Preschool Children in Burkina Faso: A Randomized, Controlled Trial.}, journal = {Clin Infect Dis}, volume = {70}, year = {2020}, month = {2020 01 16}, pages = {525-527}, abstract = {

We evaluated the effect of systemic antibiotics (azithromycin, amoxicillin, cotrimoxazole, or placebo) on the gut resistome in children aged 6 to 59 months. Azithromycin and cotrimoxazole led to an increase in macrolide and sulfonamide resistance determinants. Resistome expansion can be induced with a single course of antibiotics.

}, keywords = {Anti-Bacterial Agents, Azithromycin, Burkina Faso, Child, Preschool, Gastrointestinal Microbiome, Humans, Infant, Macrolides}, issn = {1537-6591}, doi = {10.1093/cid/ciz455}, author = {Oldenburg, Catherine E and Hinterwirth, Armin and Sie, Ali and Coulibaly, Boubacar and Ouermi, Lucienne and Dah, Clarisse and Tapsoba, Charlemagne and Cummings, Susie L and Zhong, Lina and Chen, Cindi and Sarkar, Samarpita and B{\"a}rnighausen, Till and Lietman, Thomas M and Keenan, Jeremy D and Doan, Thuy} } @article {206, title = {Rapid Reduction of Species in the Gut Microbiome of Preschool Children after Oral Azithromycin: A Randomized Controlled Trial.}, journal = {Am J Trop Med Hyg}, volume = {103}, year = {2020}, month = {2020 09}, pages = {1266-1269}, abstract = {

has emerged as a potential important cause of childhood morbidity in sub-Saharan Africa. Biannual mass azithromycin distribution has previously been shown to reduce all-cause child mortality in sub-Saharan Africa. We conducted a randomized controlled trial in Burkina Faso in which children were randomized in a 1:1 fashion to a 5-day course of azithromycin or placebo to investigate the effect of oral antibiotics on the gut microbiome. We evaluated the changes in the gut microbiome of preschool children treated with azithromycin using metagenomic DNA sequencing. We found that three species were reduced with azithromycin treatment compared with placebo. These results were consistent with other studies that have shown decreases in species after azithromycin treatment, generating the hypothesis that a decrease in may contribute to observations of reduction in mortality following azithromycin distribution.

}, keywords = {Anti-Bacterial Agents, Azithromycin, Burkina Faso, Campylobacter, Campylobacter Infections, Child Mortality, Child, Preschool, Gastrointestinal Microbiome, Humans, Infant, Metagenomics, Sequence Analysis, DNA}, issn = {1476-1645}, doi = {10.4269/ajtmh.19-0940}, author = {Hinterwirth, Armin and Sie, Ali and Coulibaly, Boubacar and Ouermi, Lucienne and Dah, Clarisse and Tapsoba, Charlemagne and Zhong, Lina and Chen, Cindi and Lietman, Thomas M and Keenan, Jeremy D and Doan, Thuy and Oldenburg, Catherine E} }