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Clin Infect Dis. 2017 May 1;64(9):1147-1153. doi: 10.1093/cid/cix141.

Gut Microbial Diversity in Antibiotic-Naive Children After Systemic Antibiotic Exposure: A Randomized Controlled Trial.

Author information

1
Francis I. Proctor Foundation, University of California San Francisco, San Francisco, California, United States of America.
2
Department of Ophthalmology, University of California, San Francisco, California, United States of America.
3
The Carter Center Niger, Republique du Niger.
4
Department of Epidemiology & Biostatistics, University of California at San Francisco, San Francisco, California, United States of America.
5
Medical Sciences, University of California-San Francisco, San Francisco, California, United States of America.

Abstract

Background:

Antibiotic exposure can alter the gut microbiome. We evaluate the effects of azithromycin on the gut microbiome diversity of children from an antibiotic-naive community in Niger.

Methods:

A population-based sample of 80 children aged 1-60 months in the Dosso region of Niger was randomized to receive a single dose of either oral azithromycin or placebo. Fecal samples were collected immediately before treatment and 5 days after treatment for 16S rRNA gene sequencing. The prespecified outcome was α-diversity (inverse Simpson's α-diversity index), with secondary outcomes of β and γ Simpson's and Shannon's diversities.

Results:

At 5 days after treatment, 40 children aged 1-60 months were analyzed in the azithromycin-treated group and 40 children in the placebo-treated group. Diversity of the gut microbiome was significantly lower in the treated group (inverse Simpson's α-diversity, 5.03; 95% confidence interval [CI], 4.08-6.14) than in the placebo group (6.91; 95% CI, 5.82-8.21; P = .03). Similarly, the Shannon's α-diversity was lower in the treated group (10.60; 95% CI, 8.82-12.36) than the placebo group (15.42; 95% CI, 13.24-17.80; P = .004). Simpson's community-level (γ) diversity decreased with azithromycin exposure from 17.72 (95% CI, 13.80-20.21) to 10.10 (95% CI, 7.80-11.40; P = .00008), although β-diversity was not significantly reduced (2.56, 95% CI, 1.88-3.12; to 2.01, 95% CI, 1.46-2.51; P = .26).

Conclusions:

Oral administration of azithromycin definitively decreases the diversity of the gut microbiome of children in an antibiotic-naive community.

Clinical Trials Registration:

NCT02048007.

KEYWORDS:

antibiotics.; azithromycin; children; gut microbiome; randomized controlled trial

PMID:
28402408
PMCID:
PMC5849050
DOI:
10.1093/cid/cix141
[Indexed for MEDLINE]
Free PMC Article

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