Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Up to Four Biannual Administrations of Mass Azithromycin Treatment Are Associated with Modest Changes in the Gut Microbiota of Rural Malawian Children

Version 1 : Received: 5 October 2020 / Approved: 6 October 2020 / Online: 6 October 2020 (15:55:40 CEST)

How to cite: Chaima, D.; Pickering, H.; Hart, J.D.; Burr, S.E.; Houghton, J.; Maleta, K.; Kalua, K.; Bailey, R.L.; Holland, M.J. Up to Four Biannual Administrations of Mass Azithromycin Treatment Are Associated with Modest Changes in the Gut Microbiota of Rural Malawian Children. Preprints 2020, 2020100138 (doi: 10.20944/preprints202010.0138.v1). Chaima, D.; Pickering, H.; Hart, J.D.; Burr, S.E.; Houghton, J.; Maleta, K.; Kalua, K.; Bailey, R.L.; Holland, M.J. Up to Four Biannual Administrations of Mass Azithromycin Treatment Are Associated with Modest Changes in the Gut Microbiota of Rural Malawian Children. Preprints 2020, 2020100138 (doi: 10.20944/preprints202010.0138.v1).

Abstract

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 to examine associations between mass drug administration (MDA) with azithromycin and the gut microbiota of rural Malawian children aged between 1-59 months. Fecal samples were collected from the children prior to treatment 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.

Subject Areas

Mass drug administration; Azithromycin; Gut microbiota; V4-16S rRNA sequencing

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