Antibiotic prescribing in infants is common across Malaysianprimary care and hospital settings. While medically necessary, antibioticcourses during the weaning window cause significant disruption to thedeveloping gut microbiome at precisely the moment when dietary transition frommilk to complementary foods is reshaping microbial diversity. This dualdisruption, pharmacological and dietary, creates a window of heightenedvulnerability to antibiotic-associated diarrhea (AAD) and immune dysregulationthat can manifest as subsequent eczema or allergic flares.
Study Aim
PEBIMR aims to address the developing microbiome disruptioncaused by pediatric antibiotics use by utilizing the hospital pharmacist—thefinal point of healthcare contact—to deliver a biotic-based rescue strategy.
Scientific Approach
PEBIMR is a 24-month, 2-arm randomized controlled trialtesting a pharmacist-led intervention to protect and restore the gut microbiomeof infants aged 6–24 months who are prescribed oral antibiotics during thecritical weaning window.
Expected Outcomes
The PEBIMR project addresses a critical clinical gap: the"double disruption" of the infant gut microbiome caused bysimultaneous antibiotic therapy and the dietary transition of weaning. Whileantibiotics are lifesaving, they deplete commensal bacteria essential forlong-term health. This study serves as a pioneering model for precisionnutrition in Southeast Asia, using biotics to "rescue" microbialdiversity during the most sensitive window of immune calibration.
