Treatment of severe malnutrition with 2-day intramuscular ceftriaxone vs 5-day amoxicillin.

Abstract Background. Systemic antibiotics are routinely prescribed for severe acute malnutrition (SAM). However, there is no consensus regarding the most suitable regimen. In a therapeutic feeding centre in Khartoum, Sudan, a randomised, unblinded, superiority-controlled trial was conducted, comparing once daily intramuscular injection with ceftriaxone for 2 days with oral amoxicillin twice daily for 5 days in children aged 6–59 months with SAM. Methods. Commencing with the first measured weight gain (WG) following admission, the risk difference and 95% confidence interval (95% CI) for children with a WG ≥ 10 g/kg/day were calculated over a 14-day period. The recovery rate and case fatality ratio (CFR) between the two groups were also calculated. Results. In an intention-to-treat analysis of 458 children, 53.5% (123/230) in the amoxicillin group and 55.7% (127/228, difference 2.2%, 95% CI −6.9–11.3) in the ceftriaxone group had a WG ≥ 10 g/kg/day during a 14-day period. Recovery rate was 70% (161/230) in ...