ArticleBulletin of the World Health Organization2017
Use of antibiotics in children younger than two years in eight countries: a prospective cohort study.
Article in Bulletin of the World Health Organization, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT06609980 (Fecal Microbiota Transplantation), which is not on this map. Cited by 139 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Fecal Microbiota Transplantation (Autologous) in Infants Treated With Antibiotics
Who cites it
139 citing papers in PubMed, 3 syntheses or guidelines pooled it, 233 citations in OpenAlex.
- Should my child be given antibiotics? A systematic review of parental decision making in rural and remote locations.Antimicrobial resistance and infection control · 2024Pooled it
- Prevalence and risk factors for antibiotic utilization in Chinese children.BMC pediatrics · 2021Pooled it
- Interventions to reduce post-acute consequences of diarrheal disease in children: a systematic review.BMC public health · 2018Pooled it
- Parenteral Vaccine-Induced Antibody Levels in Children with Heavy Antibiotic Exposure in Dhaka, Bangladesh.The American journal of tropical medicine and hygiene · 2026Trial
- Personalized azithromycin treatment rules for children with watery diarrhea using machine learning.Nature communications · 2025Trial
- Water, sanitation, handwashing, and nutritional interventions can reduce child antibiotic use: evidence from Bangladesh and Kenya.Nature communications · 2025Trial
- Homoeopathy vs. conventional primary care in children during the first 24 months of life-a pragmatic randomised controlled trial.European journal of pediatrics · 2024Trial
- Azithromycin for Bacterial Watery Diarrhea: A Reanalysis of the AntiBiotics for Children With Severe Diarrhea (ABCD) Trial Incorporating Molecular Diagnostics.The Journal of infectious diseases · 2024Trial
- Improving Antibiotic Stewardship for Diarrheal Disease With Probability-Based Electronic Clinical Decision Support: A Randomized Crossover Trial.JAMA pediatrics · 2022Trial
- Prevention of antimicrobial prescribing among infants following maternal vaccination against respiratory syncytial virus.Proceedings of the National Academy of Sciences of the United States of America · 2022Trial
- Analysis of serious adverse events in a pediatric community-acquired pneumonia randomized clinical trial in Malawi.Scientific reports · 2022Trial
- Comparing Azithromycin to Amoxicillin in the Management of Uncomplicated Severe Acute Malnutrition in Burkina Faso: A Pilot Randomized Trial.The American journal of tropical medicine and hygiene · 2022Trial
- Effect of placebo versus prophylactic postoperative amoxicillin on post-(adeno) tonsillectomy morbidity in Tanzanian children: a two-centre, double-blind randomized controlled non-inferiority trial.The Pan African medical journal · 2022Trial
- Antimicrobial Prescribing during Infant Hospital Admissions in a Birth Cohort in Dhaka, Bangladesh.Journal of tropical pediatrics · 2021Trial
- Indirect effect of oral azithromycin on the gut resistome of untreated children: a randomized controlled trial.International health · 2021Trial
- Effect of Bismuth Subsalicylate vs Placebo on Use of Antibiotics Among Adult Outpatients With Diarrhea in Pakistan: A Randomized Clinical Trial.JAMA network open · 2019Trial
- Burden of Shigella infection in children under five years living in a peri-urban area of Ouagadougou, Burkina Faso: A community-based cohort study.PLoS neglected tropical diseases · 2026Article
- Effects ofmedRxiv : the preprint server for health sciences · 2026Article
- Antibiotic Use and Care-Seeking Practices for Childhood Diarrhea and Respiratory Illnesses in Community Settings in Bangladesh: A Cross-Sectional Caregiver Survey.Antibiotics (Basel, Switzerland) · 2026Article
- Parental perceptions of antibiotic use in pediatric dentistry: a cross-sectional study using the PAPA scale.BMC oral health · 2026Article
79 more citing papers are in PubMed but not listed here.
Corrections and comments
- Erratum issuedCorrigendum.2017
Authors and funding
22 authors at 11 institutions in 9 countries.
Funding
Abstract
objectiveTo describe the frequency and factors associated with antibiotic use in early childhood, and estimate the proportion of diarrhoea and respiratory illnesses episodes treated with antibiotics.
methodsBetween 2009 and 2014, we followed 2134 children from eight sites in Bangladesh, Brazil, India, Nepal, Pakistan, Peru, South Africa and the United Republic of Tanzania, enrolled in the MAL-ED birth cohort study. We documented all antibiotic use from mothers' reports at twice-weekly visits over the children's first two years of life. We estimated the incidence of antibiotic use and the associations of antibiotic use with child and household characteristics. We described treatment patterns for diarrhoea and respiratory illnesses, and identified factors associated with treatment and antibiotic class.
findingsOver 1 346 388 total days of observation, 16 913 courses of antibiotics were recorded (an incidence of 4.9 courses per child per year), with the highest use in South Asia. Antibiotic treatment was given for 375/499 (75.2%) episodes of bloody diarrhoea and for 4274/9661 (44.2%) episodes of diarrhoea without bloody stools. Antibiotics were used in 2384/3943 (60.5%) episodes of fieldworker-confirmed acute lower respiratory tract illness as well as in 6608/16742 (39.5%) episodes of upper respiratory illness. Penicillins were used most frequently for respiratory illness, while antibiotic classes for diarrhoea treatment varied within and between sites.
conclusionRepeated antibiotic exposure was common early in life, and treatment of non-bloody diarrhoea and non-specific respiratory illnesses was not consistent with international recommendations. Rational antibiotic use programmes may have the most impact in South Asia, where antibiotic use was highest.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.