Biannual Administrations of Azithromycin and the Gastrointestinal Microbiome of Malawian Children: A Nested Cohort Study Within a Randomized Controlled Trial
Community-level mass treatment with azithromycin has been associated with a mortality benefit in children. However, antibiotic exposures result in disruption of the gut microbiota and repeated exposures may reduce recovery of the gut flora. We conducted a nested cohort study within the framework of...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-02-01
|
| Series: | Frontiers in Public Health |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2022.756318/full |
| _version_ | 1818285005018759168 |
|---|---|
| author | David Chaima David Chaima Harry Pickering John D. Hart Sarah E. Burr Sarah E. Burr Joanna Houghton Kenneth Maleta Khumbo Kalua Khumbo Kalua Robin L. Bailey Martin J. Holland |
| author_facet | David Chaima David Chaima Harry Pickering John D. Hart Sarah E. Burr Sarah E. Burr Joanna Houghton Kenneth Maleta Khumbo Kalua Khumbo Kalua Robin L. Bailey Martin J. Holland |
| author_sort | David Chaima |
| collection | DOAJ |
| description | Community-level mass treatment with azithromycin has been associated with a mortality benefit in children. However, antibiotic exposures result in disruption of the gut microbiota and repeated exposures may reduce recovery of the gut flora. We conducted a nested cohort study within the framework of a randomized controlled trial to examine associations between mass drug administration (MDA) with azithromycin and the gut microbiota of rural Malawian children aged between 1 and 59 months. Fecal samples were collected from the children at baseline and 6 months after two or four biannual rounds of azithromycin treatment. DNA was extracted from fecal samples and V4-16S rRNA sequencing used to characterize the gut microbiota. Firmicutes, Bacteroidetes, Proteobacteria and Actinobacteria were the dominant phyla while Faecalibacterium and Bifidobacterium were the most prevalent genera. There were no associations between azithromycin treatment and changes in alpha diversity, however, four biannual rounds of treatment were associated with increased abundance of Prevotella. The lack of significant changes in gut microbiota after four biannual treatments supports the use of mass azithromycin treatment to reduce mortality in children living in low- and middle-income settings. |
| first_indexed | 2024-12-13T01:01:49Z |
| format | Article |
| id | doaj.art-b0796116aae149b4b19b2ffb3847d9cc |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-12-13T01:01:49Z |
| publishDate | 2022-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-b0796116aae149b4b19b2ffb3847d9cc2022-12-22T00:04:39ZengFrontiers Media S.A.Frontiers in Public Health2296-25652022-02-011010.3389/fpubh.2022.756318756318Biannual Administrations of Azithromycin and the Gastrointestinal Microbiome of Malawian Children: A Nested Cohort Study Within a Randomized Controlled TrialDavid Chaima0David Chaima1Harry Pickering2John D. Hart3Sarah E. Burr4Sarah E. Burr5Joanna Houghton6Kenneth Maleta7Khumbo Kalua8Khumbo Kalua9Robin L. Bailey10Martin J. Holland11Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United KingdomMicrobiology Unit, Department of Pathology, College of Medicine, University of Malawi, Blantyre, MalawiClinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United KingdomClinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United KingdomClinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United KingdomMicrobiology Unit, Department of Pathology, College of Medicine, University of Malawi, Blantyre, MalawiClinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United KingdomSchool of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, MalawiBlantyre Institute of Community Outreach, Blantyre, MalawiDepartment of Ophthalmology, College of Medicine, University of Malawi, Blantyre, MalawiClinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United KingdomClinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United KingdomCommunity-level mass treatment with azithromycin has been associated with a mortality benefit in children. However, antibiotic exposures result in disruption of the gut microbiota and repeated exposures may reduce recovery of the gut flora. We conducted a nested cohort study within the framework of a randomized controlled trial to examine associations between mass drug administration (MDA) with azithromycin and the gut microbiota of rural Malawian children aged between 1 and 59 months. Fecal samples were collected from the children at baseline and 6 months after two or four biannual rounds of azithromycin treatment. DNA was extracted from fecal samples and V4-16S rRNA sequencing used to characterize the gut microbiota. Firmicutes, Bacteroidetes, Proteobacteria and Actinobacteria were the dominant phyla while Faecalibacterium and Bifidobacterium were the most prevalent genera. There were no associations between azithromycin treatment and changes in alpha diversity, however, four biannual rounds of treatment were associated with increased abundance of Prevotella. The lack of significant changes in gut microbiota after four biannual treatments supports the use of mass azithromycin treatment to reduce mortality in children living in low- and middle-income settings.https://www.frontiersin.org/articles/10.3389/fpubh.2022.756318/fullmass drug administrationazithromycingut microbiotaV4-16S rRNA sequencingamplicon |
| spellingShingle | David Chaima David Chaima Harry Pickering John D. Hart Sarah E. Burr Sarah E. Burr Joanna Houghton Kenneth Maleta Khumbo Kalua Khumbo Kalua Robin L. Bailey Martin J. Holland Biannual Administrations of Azithromycin and the Gastrointestinal Microbiome of Malawian Children: A Nested Cohort Study Within a Randomized Controlled Trial Frontiers in Public Health mass drug administration azithromycin gut microbiota V4-16S rRNA sequencing amplicon |
| title | Biannual Administrations of Azithromycin and the Gastrointestinal Microbiome of Malawian Children: A Nested Cohort Study Within a Randomized Controlled Trial |
| title_full | Biannual Administrations of Azithromycin and the Gastrointestinal Microbiome of Malawian Children: A Nested Cohort Study Within a Randomized Controlled Trial |
| title_fullStr | Biannual Administrations of Azithromycin and the Gastrointestinal Microbiome of Malawian Children: A Nested Cohort Study Within a Randomized Controlled Trial |
| title_full_unstemmed | Biannual Administrations of Azithromycin and the Gastrointestinal Microbiome of Malawian Children: A Nested Cohort Study Within a Randomized Controlled Trial |
| title_short | Biannual Administrations of Azithromycin and the Gastrointestinal Microbiome of Malawian Children: A Nested Cohort Study Within a Randomized Controlled Trial |
| title_sort | biannual administrations of azithromycin and the gastrointestinal microbiome of malawian children a nested cohort study within a randomized controlled trial |
| topic | mass drug administration azithromycin gut microbiota V4-16S rRNA sequencing amplicon |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2022.756318/full |
| work_keys_str_mv | AT davidchaima biannualadministrationsofazithromycinandthegastrointestinalmicrobiomeofmalawianchildrenanestedcohortstudywithinarandomizedcontrolledtrial AT davidchaima biannualadministrationsofazithromycinandthegastrointestinalmicrobiomeofmalawianchildrenanestedcohortstudywithinarandomizedcontrolledtrial AT harrypickering biannualadministrationsofazithromycinandthegastrointestinalmicrobiomeofmalawianchildrenanestedcohortstudywithinarandomizedcontrolledtrial AT johndhart biannualadministrationsofazithromycinandthegastrointestinalmicrobiomeofmalawianchildrenanestedcohortstudywithinarandomizedcontrolledtrial AT saraheburr biannualadministrationsofazithromycinandthegastrointestinalmicrobiomeofmalawianchildrenanestedcohortstudywithinarandomizedcontrolledtrial AT saraheburr biannualadministrationsofazithromycinandthegastrointestinalmicrobiomeofmalawianchildrenanestedcohortstudywithinarandomizedcontrolledtrial AT joannahoughton biannualadministrationsofazithromycinandthegastrointestinalmicrobiomeofmalawianchildrenanestedcohortstudywithinarandomizedcontrolledtrial AT kennethmaleta biannualadministrationsofazithromycinandthegastrointestinalmicrobiomeofmalawianchildrenanestedcohortstudywithinarandomizedcontrolledtrial AT khumbokalua biannualadministrationsofazithromycinandthegastrointestinalmicrobiomeofmalawianchildrenanestedcohortstudywithinarandomizedcontrolledtrial AT khumbokalua biannualadministrationsofazithromycinandthegastrointestinalmicrobiomeofmalawianchildrenanestedcohortstudywithinarandomizedcontrolledtrial AT robinlbailey biannualadministrationsofazithromycinandthegastrointestinalmicrobiomeofmalawianchildrenanestedcohortstudywithinarandomizedcontrolledtrial AT martinjholland biannualadministrationsofazithromycinandthegastrointestinalmicrobiomeofmalawianchildrenanestedcohortstudywithinarandomizedcontrolledtrial |