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Biannual Administrations of Azithromycin and the Gastrointestinal Microbiome of Malawian Children: A Nested Cohort Study Within a Randomized Controlled Trial

Community-level mass treatment with azithromycin has been associated with a mortality benefit in children. However, antibiotic exposures result in disruption of the gut microbiota and repeated exposures may reduce recovery of the gut flora. We conducted a nested cohort study within the framework of...

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Autores principales: Chaima, David, Pickering, Harry, Hart, John D., Burr, Sarah E., Houghton, Joanna, Maleta, Kenneth, Kalua, Khumbo, Bailey, Robin L., Holland, Martin J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8885630/
https://www.ncbi.nlm.nih.gov/pubmed/35242730
http://dx.doi.org/10.3389/fpubh.2022.756318
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author Chaima, David
Pickering, Harry
Hart, John D.
Burr, Sarah E.
Houghton, Joanna
Maleta, Kenneth
Kalua, Khumbo
Bailey, Robin L.
Holland, Martin J.
author_facet Chaima, David
Pickering, Harry
Hart, John D.
Burr, Sarah E.
Houghton, Joanna
Maleta, Kenneth
Kalua, Khumbo
Bailey, Robin L.
Holland, Martin J.
author_sort Chaima, David
collection PubMed
description Community-level mass treatment with azithromycin has been associated with a mortality benefit in children. However, antibiotic exposures result in disruption of the gut microbiota and repeated exposures may reduce recovery of the gut flora. We conducted a nested cohort study within the framework of a randomized controlled trial to examine associations between mass drug administration (MDA) with azithromycin and the gut microbiota of rural Malawian children aged between 1 and 59 months. Fecal samples were collected from the children at baseline and 6 months after two or four biannual rounds of azithromycin treatment. DNA was extracted from fecal samples and V4-16S rRNA sequencing used to characterize the gut microbiota. Firmicutes, Bacteroidetes, Proteobacteria and Actinobacteria were the dominant phyla while Faecalibacterium and Bifidobacterium were the most prevalent genera. There were no associations between azithromycin treatment and changes in alpha diversity, however, four biannual rounds of treatment were associated with increased abundance of Prevotella. The lack of significant changes in gut microbiota after four biannual treatments supports the use of mass azithromycin treatment to reduce mortality in children living in low- and middle-income settings.
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spelling pubmed-88856302022-03-02 Biannual Administrations of Azithromycin and the Gastrointestinal Microbiome of Malawian Children: A Nested Cohort Study Within a Randomized Controlled Trial Chaima, David Pickering, Harry Hart, John D. Burr, Sarah E. Houghton, Joanna Maleta, Kenneth Kalua, Khumbo Bailey, Robin L. Holland, Martin J. Front Public Health Public Health Community-level mass treatment with azithromycin has been associated with a mortality benefit in children. However, antibiotic exposures result in disruption of the gut microbiota and repeated exposures may reduce recovery of the gut flora. We conducted a nested cohort study within the framework of a randomized controlled trial to examine associations between mass drug administration (MDA) with azithromycin and the gut microbiota of rural Malawian children aged between 1 and 59 months. Fecal samples were collected from the children at baseline and 6 months after two or four biannual rounds of azithromycin treatment. DNA was extracted from fecal samples and V4-16S rRNA sequencing used to characterize the gut microbiota. Firmicutes, Bacteroidetes, Proteobacteria and Actinobacteria were the dominant phyla while Faecalibacterium and Bifidobacterium were the most prevalent genera. There were no associations between azithromycin treatment and changes in alpha diversity, however, four biannual rounds of treatment were associated with increased abundance of Prevotella. The lack of significant changes in gut microbiota after four biannual treatments supports the use of mass azithromycin treatment to reduce mortality in children living in low- and middle-income settings. Frontiers Media S.A. 2022-02-15 /pmc/articles/PMC8885630/ /pubmed/35242730 http://dx.doi.org/10.3389/fpubh.2022.756318 Text en Copyright © 2022 Chaima, Pickering, Hart, Burr, Houghton, Maleta, Kalua, Bailey and Holland. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Public Health
Chaima, David
Pickering, Harry
Hart, John D.
Burr, Sarah E.
Houghton, Joanna
Maleta, Kenneth
Kalua, Khumbo
Bailey, Robin L.
Holland, Martin J.
Biannual Administrations of Azithromycin and the Gastrointestinal Microbiome of Malawian Children: A Nested Cohort Study Within a Randomized Controlled Trial
title Biannual Administrations of Azithromycin and the Gastrointestinal Microbiome of Malawian Children: A Nested Cohort Study Within a Randomized Controlled Trial
title_full Biannual Administrations of Azithromycin and the Gastrointestinal Microbiome of Malawian Children: A Nested Cohort Study Within a Randomized Controlled Trial
title_fullStr Biannual Administrations of Azithromycin and the Gastrointestinal Microbiome of Malawian Children: A Nested Cohort Study Within a Randomized Controlled Trial
title_full_unstemmed Biannual Administrations of Azithromycin and the Gastrointestinal Microbiome of Malawian Children: A Nested Cohort Study Within a Randomized Controlled Trial
title_short Biannual Administrations of Azithromycin and the Gastrointestinal Microbiome of Malawian Children: A Nested Cohort Study Within a Randomized Controlled Trial
title_sort biannual administrations of azithromycin and the gastrointestinal microbiome of malawian children: a nested cohort study within a randomized controlled trial
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8885630/
https://www.ncbi.nlm.nih.gov/pubmed/35242730
http://dx.doi.org/10.3389/fpubh.2022.756318
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