Nature communications · 2025
Water, sanitation, handwashing, and nutritional interventions can reduce child antibiotic use: evidence from Bangladesh and Kenya.
СтатьяМногоцентровое исследованиеРандомизированное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Ercumen Ayse, Mertens Andrew N, Butzin-Dozier Zachary, Jung Da Kyung, Ali Shahjahan, Achando Beryl S, Rao Gouthami, Hemlock Caitlin, Pickering Amy J, Stewart Christine P, Tan Sophia T, Grembi Jessica A, Benjamin-Chung Jade, Wolfe Marlene, Ho Gene G, Rahman Md Ziaur, Arnold Charles D, Dentz Holly N, Njenga Sammy M, Meerkerk Theodora, Chen Belinda, Nadimpalli Maya, Islam Mohammad Aminul, Hubbard Alan E, Null Clair, Unicomb Leanne, Rahman Mahbubur, Colford John M, Luby Stephen P, Arnold Benjamin F, Lin Audrie
Аннотация
Antibiotics can trigger antimicrobial resistance and microbiome alterations. Reducing pathogen exposure and undernutrition can reduce infections and antibiotic use. We assess effects of water, sanitation, handwashing (WSH) and nutrition interventions on caregiver-reported antibiotic use in Bangladesh and Kenya, longitudinally measured at three timepoints among birth cohorts (ages 3-28 months) in a cluster-randomized trial. Over 50% of children used antibiotics at least once in the 90 days preceding data collection. In Bangladesh, the prevalence of antibiotic use was 10-14% lower in groups receiving WSH (prevalence ratio [PR] = 0.90 (0.82-0.99)), nutrition (PR = 0.86 (0.78-0.94)), and nutrition+WSH (PR = 0.86 (0.79-0.93)) interventions. The prevalence of using antibiotics multiple times was 26-35% lower in intervention arms. Reductions were largest when the birth cohort was younger. In Kenya, interventions did not affect antibiotic use. In this work, we show that improving WSH and nutrition can reduce antibiotic use. Studies should assess whether such reductions translate to reduced antimicrobial resistance.