Distribution of antibiotic for eye disease linked to low death risk among Ethiopian children

Sep 01, 2009

Children in Ethiopia who received the antibiotic azithromycin as a method for controlling the contagious eye disease trachoma had a lower odds of death compared to children who did not receive the antibiotic, according to a study in the September 2 issue of JAMA.

"The World Health Organization has recommended mass distribution and administration of oral azithromycin as part of efforts to control blinding trachoma. Such distribution has proven effective against the ocular strains of that cause the disease at both the individual and village levels," the authors write. The treatment may also have unintended consequences, both harmful and beneficial, including the inducement of . "Conversely, antibiotics may reduce both respiratory and gastrointestinal infections, and possibly reduce rates of malaria—all of which are major causes of death in children in trachoma-endemic areas such as rural Ethiopia."

Travis C. Porco, Ph.D., M.P.H., of the University of California, San Francisco, and colleagues examined the effect of oral azithromycin distribution for trachoma control on mortality among children ages 1 to 9 in Ethiopia. Forty-eight communities (known as subkebeles) were randomized into 1 of 3 treatment schedules (annual treatment of all residents [15,902 participants], biannual treatment of all residents [17,288 participants], or quarterly treatment of children only [14,716 participants]) or into 1 group for which treatment was delayed by 1 year (control, 18,498 participants). Twelve subkebeles were randomized to each of the 4 schedules with all children in each of the three communities being eligible for treatment. The trial was conducted in a field setting in rural Ethiopia, May 2006 to May 2007. Antibiotic coverage rates exceeded 81 percent among children age 1 to 9 years at all visits.

A total of 82 deaths were recorded for children age 1 to 9 years at the 2007 census. Comparing the mortality rates between the two groups, the researchers found that the children in the treatment group had a 49 percent lower odds of death compared with children in the control group.

"It is not clear precisely why azithromycin decreased mortality, although infectious diseases are the leading cause of death in Ethiopian children, in particular pneumonia (28 percent), diarrhea (20 percent), and malaria (20 percent). In Ethiopia, azithromycin is likely effective against the major pathogenic causes of lower respiratory infections such as Streptococcus pneumoniae and Haemophilus influenzae, and may have some effect against major causes of bacterial diarrhea such as Escherichia coli and Clostridium jejuni. Azithromycin has also been shown to have efficacy in the prevention and treatment of malaria due to both Plasmodium falciparum and Plasmodium vivax," the authors write.

"The dangers of nonspecific antibiotic use have been well-described in the scientific literature. The common wisdom is that overprescribing antibiotics results in increased morbidity and mortality from drug-resistant organisms, and that society would be better off were physicians to restrain their use of the drugs. However, the effect of nonspecific mass antibiotic use on mortality has never before been assessed in a group-randomized clinical trial. In an area in which residents have very limited access to antibiotics, mass distribution of oral azithromycin appears to reduce mortality in preschool . Further assessment of the mechanism, generalizability, effects of drug resistance or other adverse outcomes, and cost-effectiveness of antibiotic administration in impoverished rural settings may be needed to provide further insight to guide public health policy."

More information: JAMA. 2009;302[9]:962-968.

Source: JAMA and Archives Journals (news : web)

Explore further: MSF fighting cholera outbreak in Tanzania refugee camps

Related Stories

Antibiotic use in infants linked to asthma

Jun 11, 2007

New research indicates that children who receive antibiotics before their first birthday are significantly more likely to develop asthma by age 7. The study, published in the June issue of CHEST, the peer-reviewed journal ...

Recommended for you

Aspirin to improve leg ulcers

3 hours ago

Researchers are looking at whether aspirin can improve the healing rates of leg ulcers in older adults.

Sierra Leone marks grim Ebola anniversary

7 hours ago

On May 24 last year a pregnant woman and an older housewife staggered into Kenema hospital in eastern Sierra Leone and were diagnosed within a day as the country's first Ebola cases.

MSF fighting cholera outbreak in Tanzania refugee camps

May 24, 2015

Medical charity Medecins sans Frontieres (MSF, Doctors Without Borders) said Sunday it had launched emergency treatment centres in Tanzania, where thousands of Burundians fleeing unrest have been hit by cholera.

Bacteria blamed in indigenous Mexican baby deaths

May 23, 2015

Bacteria—and not a contaminated vaccine as initially suspected—were to blame for the recent deaths of two Mexican babies and for sickening 29 others, according to an official investigation.

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.