A new study suggests that the current recommendation to treat severely malnourished children with routine antibiotics does not increase the likelihood of nutritional recovery in uncomplicated cases. Given this finding, the study’s authors say that routinely using antibiotics may not be necessary or beneficial for severely malnourished children being treated at home when there is adequate local health infrastructure.

Reducing routine antibiotic use would be prudent given global concern over the problem of antibiotic resistance, say the researchers.

The study appears in the February 4, 2016 issue of the New England Journal of Medicine (NEJM).

The new findings challenge the World Health Organization’s (WHO) current guidelines that children with uncomplicated severe acute malnutrition (SAM) always be given antibiotics, whether or not they need them.

“Our results from Niger were surprising, as they challenge the current WHO recommendations and a recent well-conducted trial from Malawi. It’s an exciting step forward though, as we hope that this new evidence will motivate a deeper review of current recommendations and the evidence on which they are based,” said Sheila Isanaka, assistant professor of nutrition at Harvard T.H. Chan School of Public Health and lead author of the study.

SAM contributes to high child mortality in many places throughout the world, affecting about 34 million children under age 5.

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