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Any new global recommendations planned for most effective antibiotics for SAM with complications?

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Wendy Dyment

Sr. Health and Nutrition Advisor, Medair

Normal user

14 Oct 2015, 19:51

The global recommendations for antibiotic treatment of SAM with complications such as the lethargic, hypoglycemic, hypothermic or suspected septic child requiring inpatient care do not seem to have changed much despite globally changing resistance patterns since WHO's guidelines in 1999. WHO's Hospital Care for Sick Children in 2013 and the UN SCN guidelines had few changes. WHO's 2013 Updates on the Management of SAM did not really touch much on this. The CMAM Forum Technical Brief on SAM and Infection from 2013 raised lots of key points regarding changing resistance patterns and the need for more study on the most effective treatment regimens for these and other patients. In the setting of nutritional emergencies and field based stabilization centres with little access to lab tests such as blood cultures, resistance patterns and x-rays, I am wondering if there are any planned new global updates in this area or if the research is still pending. In the mean time I notice some areas continue with amp and gent as second line treatment with chloramphenicol to be added if no improvement in 48 hours and some areas like W. Africa have guidelines added options of Cefotaxime, amoxicillin/clavulanic acid with amoxicillin resistance and included IM Cefotaxime and oral ciprofloxacin as a second line option. I realize this needs to link to local resistance patterns but just wondering if there are any planned global updates in the works for this area of SAM treatment. Thanks.

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