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9 g/kg/day (95% CI 0.2 to 1.6 g/kg/day, P = 0.01) more than children in the placebo arm. There was no difference in weight gain velocity in children receiving azithromycin compared to placebo at 6 months (mean difference 0.04 g/kg/day, 95% CI - 0.05 to 0.13 g/kg/day, P = 0.46). There were no significant differences in other anthropometric outcomes. Transient increases in weight gain were observed after oral azithromycin treatment, which may provide short-term benefits. ClinicalTrials.gov NCT03676751 . Registered 19/09/2018. ClinicalTr