Rogawski ET et al. – This MAL–ED (Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health) study evaluated the impact of early antibiotic use on physical growth of children from 6 months to 2 years of age. The study demonstrated that antibiotic use in low–resource settings was associated with increased growth of children who had multiple exposures to broad spectrum and anaerobic activity during early infancy (N = 1954). In addition, a rational and the targeted antibiotic therapy in low resource settings led to short–term weight gain in children, although the impact on long–term physical growth and metabolism were unknown.

Methods

• Maternally reported antibiotic exposures were recorded in the children twice per week from birth to 2 years and anthropometry was measured monthly.
• The association between antibiotic use and weight–for–age (WAZ) and length–for–age (LAZ) z scores were estimated.
• The impact of class–specific exposures and duration was evaluated, and these results were compared with the effects of antibiotic exposures after 6 months of age.

Results

• Antibiotic use before 6 months of age was associated with increased weight from 6 months to 2 years, whereas length was less consistent across sites and antibiotic classes.
• The unexposed children when compared to children who had 2 or more courses of metronidazole, macrolides, and cephalosporin were associated with adjusted increase in weight–for–age of 0.24, 0.23, and 0.19 from 6 months to 2 years, respectively.