Antibiotics alone may not overcome stunted growth

Oct. 11, 2021

Antibiotics alone likely cannot overcome the complex factors that cause stunted growth and perpetuate the cycle of poverty in the developing world, new research suggests, according to a news release from the University of Virginia.

An international team of researchers had hoped that some combination of antibiotics, Vitamin B3 and a drug to treat diarrhea would lead to better growth for children in the African country of Tanzania. But a randomized, double-blinded study following almost 1,200 children found no benefit — half the children still suffered stunted growth.

It was a disappointing result in a bid to address a crisis that plagues much of the world. But the researchers say the insights from their work will help focus future efforts in more productive directions.

“We know that the majority of these children carry intestinal pathogens in their gut,” said researcher Mark DeBoer, MD, of UVA Children’s and UVA’s Child Health Research Center. “But intervention with periodic antimicrobials did not improve their growth. It appears a much more comprehensive approach is required.”

The new study represents a collaboration of researchers at the UVA School of Medicine and Virginia Commonwealth University with colleagues in Tanzania, the United Kingdom and Norway. The scientists wanted to measure the effect of antimicrobials and vitamin supplementation in battling stunted growth, a condition often accompanied by impaired cognitive development and decreased school performance. These disadvantages then limit the children’s job possibilities and earning potential, continuing the cycle of poverty.

The researchers followed 1,188 pairs of mother and child in rural Haydom, Tanzania, from the time the children were no more than two weeks old to 18 months. The children were selected at random to receive the antibiotic azithromycin and the antiparasitic drug nitazoxanide and/or niacin, a form of Vitamin B3.

The researchers had hoped vitamin supplementation might help because the diet in Tanzania relies so heavily on corn. Nitazoxanide and azithromycin, meanwhile, can be used to treat diarrhea by targeting parasites and bacteria that cause it.

Neither approach worked. In a new scientific paper outlining their findings, the researchers suggest their interventions may not have sufficiently reduced the pathogens that cause diarrhea, that reducing pathogens may not improve growth or that the interventions were overwhelmed by other complex health challenges in the area.

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