Increased risk of acquisition and transmission of Extended Spectrum Beta-Lactamases producing Enterobacteriaceae in malnourished children exposed to amoxicillin

Antibiotics are considered a risk factor for ESBL-E carriage in the community10,11 but their role in ESBL-E dissemination remains unclear. Some studies reported transmission events4, particularly between individuals sharing the same household 12,13, but the role of narrow-spectrum antibiotics such as amoxicillin have not been explored yet. Here, taking advantage of a large randomized controlled trial in Niger evaluating the role of routine amoxicillin on nutritional recovery14, we performed an ancillary study to evaluate the role of amoxicillin on ESBL-E intestinal acquisition in children exposed to amoxicillin and transmission to their siblings.