Editorials

Antibiotics to promote growth in children?

BMJ 2014; 348 doi: https://doi.org/10.1136/bmj.g2624 (Published 15 April 2014) Cite this as: BMJ 2014;348:g2624
  1. Zulfiqar A Bhutta, Robert Harding chair in global child health and policy1, founding director2
  1. 1Center for Global Child Health, Hospital for Sick Children, Toronto, ON, Canada M5G 0A4
  2. 2Center of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
  1. zulfiqar.bhutta@sickkids.ca

Worth studying in highly selected children, with a close eye on potential harms

Overt infections are a leading cause of death worldwide in children under 5,1 and strategies to prevent and treat infections are a cornerstone of child survival programmes. Recent assessments suggest that despite a net increase in the size of birth cohorts, the number of children dying before their fifth birthday has fallen to 6.6 million (uncertainty range 6.3-7.0 million) per year, a 45% reduction from almost 12 million deaths in 1990.2 In contrast, the fall in undernutrition has been modest at best. An estimated 165 million children under 5 were stunted in 2011 and an estimated 52 million severely wasted; almost 45% of the current burden from child mortality in under 5s can be attributed to malnutrition.3 Although many risk factors for early child mortality are well recognised, the mechanisms underlying chronic enteropathy and growth failure among children in low and middle income countries remain uncertain.4

In a linked paper, Gough and colleagues (doi:10.1136/bmj.g2267) report a systematic review of 10 trials looking for associations between antibiotics, given for a variety of indications, and growth in childhood. …

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